Campaign Planning Form

Employer

Company

Campaign Coordinator

Campaign Coordinator's Email

Campaign Coordinator's Phone

Address

City

State

Zip Code

Have they conducted a UW campaign before?

Yes

Number of Employees

Notes about employer

Campaign

Planned dates of campaign

Campaign Kickoff Date, Time and planned activity

Shall we set up an online pledge card?

Yes

Number of Pay Periods (all options)

Any required fields for HR (dept/emp number)?

Payroll Payment Beginning & End Dates

Expected Payments

Bimonthly

Monthly

Quarterly

Biannual

One Time

Order Materials - Please enter a number for each ...

Paper Pledge Cards

Flyers

Comments

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