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Many of our workplace partners have undergone significant changes in the last several months. 

We want to be sure we have the correct contact information for your organization and that we can craft a campaign customized for your current work environment. If you have any questions or concerns please call Community Relations Manager, Raechel Reinitz, at 314-605-6604. 

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* 1. Company Name

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* 2. Local CEO or Manager Name

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* 3. Local CEO or Manager email

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* 4. Employee Campaign Champion (ECC) Name

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* 5. ECC email

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* 6. ECC phone number

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* 7. Human Resources Contact Name

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* 8. HR email

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* 9. HR phone number

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* 10. How has the COVID-19 crisis affected your workplace? (Check all that apply)

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* 11. Looking to this fall's campaign and the current health crisis, what type of United Way Campaign Would your organization be interested in? (Check all that apply)

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* 12. How many employees do you have?

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* 13. What Campaign items would you like included in your ECC swag bag?

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* 14. Have you decided on a date for your campaign? If yes, when? 

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* 15. How is your organization able to connect virtually? (Check all that apply)

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* 16. When will payroll deduction begin for this campaign?

Date

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* 17. How many pay periods will your employees have to complete the pledge?

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* 18. Would you like more information on any of the following opportunities for your workplace?

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* 19. Thank you for your time. Please add anything here we failed to ask about or that we should know.

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