Name ___________________________________________________

Address_________________________________________________________________________________________________

$_______________Total Gift

$ ____________Paid Now $ ____________Balance Due $ Total _____________Bill me starting January 1 Gift ❏ Quarterly ❏ Monthly

❏ Other _____________ date

Signature____________________________________    Date ______________________

No goods or services were given in exchange for this contribution

LIVE UNITED

United Way of K.C. Partner Agencies

Alpha Center,  K.C. Community Medical Clinic, Alston Wilkes Society, K.C. Council on Aging, American Red Cross, K.C. Service Center of K.C., Foster and Adoptive Parents Association,The Central S.C. Chapter K.C. Literacy Association, CamdenK.C. Rescue Squad, K.C. Teen Health Promotion Coalition, Camp Fun Sun, Mental Health America of K.C., Girl Scouts of S.C. of the Midlands, Crisis Chaplaincy, Family Service Center, Mt. Pisgah/Buffalo Rescue Squad, Indian Waters Council, B.S.A., Sistercare, Inc., K.C. Board of Disabilities and Special Needs, The Family Resource Center

Thank you for supporting our Community!

Please designate my pledge to _____________________________________ partner agency or other United Way

__________________________________________________________________________________________

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Mail Card and Donation to: The United Way of Kershaw County,    110 East DeKalb St., Camden, S.C. 29020