Pledge Red :: Company Partnership Signup Form

To submit your form, please fill out the following form and upload/attach your document(s).

* = required

Company Contact Information
* Company Name:
* CEO/Partner Name:
* Contact Person Name:
Contact Person Title:
* Contact Email:
*Address:
*City:
*State:
*Zip Code:
Phone Number
Fax Number
Payroll Information
* # of Employees:
* # of pay periods per year:
* How is your payroll processed?   Internally  --  Payroll Software: 
  Externally  --  Payroll Service: 
*Payroll Contact Person Name:
* Payroll Contact Email:
* Payroll Contact Phone:
Pledge Red Program Information
* When would you like to start your Pledge Red Program?
* Would you like to offer a credit card payment option on your pledge form?   Yes   No
* Will your company provide matching funds for employee donations?   Yes   No
If yes, please provide details about any restrictions or guidelines:
* Will your company provide matching funds for donations made at a spouse’s company?   Yes   No
If yes, please provide details about any restrictions or guidelines:
Publicity
*May we include your company name in our press releases and publicity
about the Pledge Red program?		   Yes   No
*May we include your company logo and description on our PlegeRed website?   Yes   No
    Notice:
  • Uploaded file must not exceed 2MB.
  • The 'company logo' should be in one of the file extensions: 'jpg', 'gif', 'tiff', 'png', 'eps'.
1. Upload your company logo:
2. Provide your 1-paragraph company description: *
3. Provide a short explanation of why your company has chosen to support the Washtenaw County Red Cross by participating in Pledge Red :