Donate to the United Way of Johnson and Washington Counties to join us in helping to improve lives within your community. University of Iowa Donation Form Donor Information First Name Last Name Home Address City State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Email Address Phone Number Giving through your workplace? Please list your employer below. Employer Department Credit Card Donation Would you be willing to cover the 3% online processing fee? Yes No Frequency of Your Donation One-Time Donation Recurring Donation (monthly) Recurring Donation (every 3 months) Recurring gifts will occur perpetually until you notify our office to stop payments. You may provide special instructions in the "Donor Notes" field below. One-Time Amount $10 $25 $50 $100 $250 $500 Other… Please enter your amount $ Monthly Recurring Amount $5/month ($5.15/month charged) $10/month ($10.30/month charged) $25/month ($25.75/month charged) $50/month ($51.50/month charged) $100/month ($103/month charged) $250/month ($257.50/month charged) Quarterly Recurring Amount $50/quarter ($51.50/quarter charged) $125/quarter ($128.75/quarter charged) $250/quarter ($257.50/quarter charged) $500/quarter ($515/quarter charged) $1000/quarter ($1030/quarter charged) $1,250/quarter ($1287.50/quarter charged) Frequency of Your Donation One-Time Donation Recurring Donation (monthly) Recurring Donation (every 3 months) Recurring gifts will occur perpetually until you notify our office to stop payments. You may provide special instructions in the "Donor Notes" field below. One-Time Amount $10 $25 $50 $100 $250 $500 Other… Please enter your amount $ Monthly Recurring Amount $5/month $10/month $25/month $50/month $100/month $250/month Quarterly Recurring Amount $50/quarter $125/quarter $250/quarter $500/quarter $1000/quarter $1,250/quarter Notes about your donation to United Way Payment Information Preview
