United Way of Berks County

Emerging Leaders United Membership Form

* Prefix

* First Name

* Last Name

* Home Address

Home address line 2

* City

* State

* Zip Code

* Employer

* Work email address

* Personal email address

What is your preferred email address?

Work

Personal

Cell number

* I certify that I am between the ages of 21-45.

What areas of United Way's Work interest you most? (check all that apply)

Education (Helping children and youth reach their potential)

Health (Improving people's health)

Financial Stability (Promoting self-sufficiency and independence)

Safety Net Services (Helping people meet basic needs; supporting crisis and disaster response services)

How did you hear about Emerging Leaders United?

Items marked with an asterisk(*) are required

The official registration and financial information of the United Way of Berks County (UWBC) may be obtained from the Pennsylvania Department of State by calling toll free 800-732-0999. Registration does not imply endorsement.

Please note: If you select Payroll Deduction and submit your voluntary pledge to United Way of Berks County, you authorize your employer to make the one-time or recurring deduction from your pay as noted. Learn more about your pledge.

Your privacy is important to us. To learn how we will use your personal information, please read our Privacy Policy

United Way of Berks County | 25 N. 2nd Street, Suite 101 | 610-685-4550 | unitedway@uwberks.org