The Pledge Form

Please use a ball-point pen and press firmly. All information on all three copies must be legible. You may donate to the CFC anonymously by placing your confidential gift in a sealed envelope.

By Payroll Deduction: Payroll deductions authorized in the Fall 2016 campaign will begin the first pay period in January, 2017 and will automatically terminate with the last pay period in December, 2017. You must sign the pledge form to authorize payroll deduction.

By Cash or Check: If donating by cash or check, simply list your total gift. Retirees and Contractors can participate in the CFC by using this method to donate. Mail the pledge form along with your check or money order to the CFC of East PA & South Jersey to CFC, Attn: Campaign Director, 1709 Benjamin Franklin Parkway, Phila., PA 19103.

Designate the charity or charities of your choice. You may only select charities that appear in our campaign area's contributor's guide. For a hard copy of the contributor’s guide, call Valerie Brown at 609-267-4500 x100 or e-mail

  • Link to the Contributor's Guide to find an agency and its code
  • List the five-digit code of each charitable group you are designating and the annual amount to that group.
  • All designations must add up to the total annual gift.

Release of name, home address or E-mail address -- Signify whether or not you want your name and/or contact information released to the charitable groups you designated.

Deliver to your Keyperson – The top two copies of your form should be given to the CFC point of contact at your workplace. The top copy goes to the payroll office to initiate the payroll deduction; the second copy will be used to process your designations. The third copy is for your records.

Pledge Form available for download