United Way of Central New Mexico

First and Last Name: *
Address:
City:
State:
Zip Code:
I We give through United Way of Central New Mexico
To the order of :
		$

* To address your donation by couple please complete the First and Last Name field as you want it to
be listed: Mr. and Mrs. Richard Smith OR Maria Garcia and Jim Chavez

Please note: filling out this form does not notify United Way of Central New Mexico of your gift intentions. Please contact Jeanette Salazar at 505-247-3671 or jeanette.salazar@uwcnm.org with your designation instructions by the 10th of the month.