United Way Wayne & Holmes Counties

Hummel Group payroll deduction contribution form

Use this form to give to United Way Wayne & Holmes Counties through payroll deduction. Your gift supports the Greatest Need in Wayne County and Holmes County, or you can direct it to a focus area, program, local nonprofit or other United Way below.

* Indicates required question

Your information

We'll send a copy of your contribution here.

How would you like to be listed in our Annual Report? *

Your gift

Donation amount per pay *
How many paychecks per year do you receive? *

Total donation amount

$0.00 Amount per pay × paychecks per year

Leadership giving levels

  1. Tocqueville Society Your level $10,000+
  2. Diamond Your level $7,000–$9,999
  3. Slate Your level $6,000–$6,999
  4. Alabaster Your level $3,000–$5,999
  5. Marble Your level $2,000–$2,999
  6. Granite Your level $1,500–$1,999
  7. Limestone Your level $1,200–$1,499
  8. Sandstone Your level $1,000–$1,199

Designation area

Your gift helps the Greatest Need in Wayne County and Holmes County. To direct your donation to one or more focus areas, programs, local nonprofits* or other United Ways, check them below. If you leave everything unchecked, your gift goes to the Greatest Need. To give directly to a local nonprofit or other United Way, choose Other and name it. Donations must total $26.00 or more to use this feature.

Direct my donation to (choose all that apply)

*We will verify each charity's compliance with the State of Ohio before forwarding your donation. If it is not compliant, we will contact you to discuss next steps.

Type your full name to sign this form.