Leadership Giving

Emerging

a - $ 250.00

b - $ 500.00

c - $ 750.00

Leadership

d - $ 1,000.00

e - $ 2,500.00

f - $ 5,000.00

Tocqueville

g - $ 10,000.00

Other Amount

Total Amount

I want to contribute this amount every month

Donor Information

Title

First Name *

Last Name *

Company/Union

Job Title

Street Address *

City *

State *

Zip Code *

Email Address *

Phone

Donor Designations

Long Island Impact Fund - Helping families afford basic needs & gain access to resources.

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

In Honor Of In Memory Of

Recognize someone who has made a significant impact on your life.

In Honor/In Memory Of

Name of Person

Family Member to Notify

Full Mailing Address for Acknowledgement

Email Address For Acknowledgement

United Way of Long Island's most recent financial reports are accessible at www.unitedwayli.org/aboutus/financial-information. And, the New York State Office of the Attorney General may be contacted at 212.416.8401, or by visiting www.charitiesnys.com, if necessary.

Donor Designations

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