Pacesetter Sign Up

Pacesetter Sign Up

To sign up as a Pacesetter, please complete the form below. For assistance, call (580) 355-0218 or contact Judy Dial.

Organization Name *

Name of Chief Executive Officer *

Number of Employees *

Name of Employee Campaign Coordinator(s) *

Employee Campaign Coordinator(s) are responsible for executing the United Way Campaign at your organization. If your organization is large, you may choose to have more than one Employee Campaign Coordinator. Please provide us with the name(s) of all Employee Campaign Coordinators.

Employee Campaign Coordinator(s) Office Phone Number *

Please provide the phone number(s) of the Employee Campaign Coordinator(s) below including extension(s).

Employee Campaign Coordinator(s) Cell Phone Number *

Please provide the cell phone number(s) for the Employee Campaign Coordinator(s) below including area code(s).

Employee Campaign Coordinator(s) Email Address *

Please provide the email address(s) of your Employee Campaign Coordinator(s) below. This will be the main source of contact between United Way of Southwest Oklahoma and the Employee Campaign Coordinator.

Organization's Pacesetter Fundraising Goal for 2019 *

Please indicate the amount of money your organization hopes to raise during this year's United Way Fundraising Campaign.

Number attending the Pacesetter Kickoff Luncheon on July 19th, 2019 *

The Pacesetter Luncheon, hosted by Comanche County Memorial Hospital, will be held on Friday, July 19th, 2019, at 12:00 pm in the Oakwood Room, (CCMH-Outpatient Center; 110 NW 31st Street, Lawton, OK 73505).

Campaign Dates for Pacesetters *

I acknowledge that my organization will run a pacesetter campaign from July 19 to September 27, 2019.

Yes

We use our own Organization Pledge Forms *

If your organization has its own pledge forms and will NOT need to use United Way of Southwest Oklahoma's pledge forms please let us know by selecting YES below.

Yes

Search form