Diaper Drive Donations | United Way of South Wood & Adams Counties

*All fields marked with an asterisk are required and must be completed to submit the form.

Organization Name

First Name

Last Name

Email

Phone

Street Address

City

State

Postal Code

Contribution Information

Amount

$10

$25

$50

$100

$250

$500

Other

Amount of Other Donation

$

Would you be willing to add the 3% credit card processing fee, so that 100% of your donation goes towards the Diaper Drive?

Yes

No

Payment Information