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Pennies for Change Form

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Pennies for Change™:  Financial Institution Form

For information about how to make the United Way's Pennies for Change™ Program available to your customers and members, please fill in the following information. United Way will contact you within 1 - 2 business days.

         
   
   
   
   
Note:  Please write out the full name of the Financial Institution .


Location of Financial Institution:
                
   

Limitation of Liability

Terms and conditions may vary by participating financial institution.  Neither United Way of America or Waldron Holdings, or any of their respective officers, directors, employees, members, agents or representatives shall have any liability to individual program participants under any cause of action for any claims, losses or damages whatsoever arising from participation in the Pennies for Change™ Program.