Campaign Central

Roster Information

A name is a very personal thing.  Most people have preferences related to the use of their name.  We have developed this form in an effort to provide an opportunity for you to communicate your preferences to us, and for us to explain the various ways we may use your name. 

Please fill out the information listed below.  If you have any questions or concerns, please call Jo Ann Carraway  at 463-5026.  Please check out the United Way of the Greater Triangle online events calendar for upcoming Leadership Events, as well as to view our annual Leadership magazine. All information you provide is kept completely confidential; we will not release it without your consent. Thank you.

• Mailing Name: The name used on the front of the envelope when addressing correspondence.
• Salutation: The name used when addressing you in a letter, i.e. Dear_____,
• Roster Name: How you wish to be recognized in the Leadership magazine.  Respectful of the fact that giving at the generous levels of Leadership Circle is a family decision, this name listing may include your spouse/partner, family, children, "In Memory of." etc. 

You may also choose to remain anonymous by indicating so under the Roster Name.

Yes, I would like to receive a hardcopy of the Leadership Magazine mailed to my home.

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Mailing Name

Salutation

Roster Name

Home Address

Home Phone

E-Mail Address

Company Name

Work Phone

Please combine my gift with the following person's gift, and recognize us as listed above:

Name

Workplace

Yes, I would like to receive a hardcopy of the Leadership Magazine mailed to my home.