https://www.berkshireunitedway.org/ en https://www.berkshireunitedway.org/chp-campaign-0 <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">CHP Campaign</span> <div class="field field--name-field-header-image field--type-image field--label-hidden field__item"> <img loading="lazy" src="/sites/berkshireunitedway/files/styles/internal_page_header/public/CHP%20header%20A.jpg?h=c57fa6b7&amp;itok=SPwCbcSl" width="2000" height="450" alt="" typeof="foaf:Image" class="image-style-internal-page-header" /> </div> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/user/262" typeof="schema:Person" property="schema:name" datatype="">gweber</span></span> <span property="schema:dateCreated" content="2025-10-07T17:54:14+00:00" class="field field--name-created field--type-created field--label-hidden">Tue, 10/07/2025 - 1:54pm</span> <div property="schema:text" class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p><img src="/sites/berkshireunitedway/files/2025-10/CHP%2050th.jpg" width="390" /><br /> <h3>Through your employee giving campaign, <span style="color:#ffba00;"><u>YOU</u></span> have a tremendous opportunity to support children, families, and individuals in Berkshire County.</h3> <p><span style="font-size:20px;">Employee giving campaigns are the backbone of Berkshire United Way's fundraising. Your contribution, and those of your colleagues, support 29 organizations and more than 17,000 neighbors in need.</span></p> <p><span style="font-size:20px;">Your donation enables us to invest in community partners doing incredible work every day to improve the quality of life here in Berkshire County.</span></p> <p><span style="font-size:20px;">Together, we are building a stronger and more equitable Berkshire County where everyone can </span><span style="color:#ff443b;"><span style="font-size:22px;"><strong>THRIVE! </strong></span></span><span style="font-size:20px;">Thank you for your commitment to your neighbors and our community through your campaign pledge (see form below).</span></p> <h3>Your contribution supports these organizations</h3> </div> <div class="paragraph paragraph--type--bp-columns paragraph--view-mode--default" id="vbp-6610" > <div class="row"> <div class="col-12"> <div class="row"> <div class="col-lg-4" > <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-6607" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p><span style="font-size:20px;">18 Degrees</span></p> <p><span style="font-size:20px;">Arts in Recovery for Youth (AIRY)</span></p> <p><span style="font-size:20px;">Barrington Stage Company</span></p> <p><span style="font-size:20px;">Berkshire Community Diaper Project</span></p> <p><span style="font-size:20px;">Berkshire County Head Start</span></p> <p><span style="font-size:20px;">Berkshire County Kids’ Place and Violence Prevention Center</span></p> <p><span style="font-size:20px;">Berkshire Hills Regional School District</span></p> <p><span style="font-size:20px;">Berkshire HorseWorks</span></p> <p><span style="font-size:20px;">Berkshire Nursing Families</span></p> <p><span style="font-size:20px;">Berkshire Pulse</span></p> </div> </div> </div> </div> </div> <div class="col-lg-4" > <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-6608" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p><span style="font-size:20px;">Berkshire South Regional Community Center</span></p> <p><span style="font-size:20px;">Berkshire Theatre Group</span></p> <p><span style="font-size:20px;">Central Berkshire Habitat for Humanity</span></p> <p><span style="font-size:20px;">Child Care of the Berkshires</span></p> <p><span style="font-size:20px;">Community Health Programs</span></p> <p><span style="font-size:20px;">Dalton Community Recreation Association</span></p> <p><span style="font-size:20px;">Elizabeth Freeman Center</span></p> <p><span style="font-size:20px;">Flying Cloud Institute</span></p> <p><span style="font-size:20px;">George B. Crane Memorial Center</span></p> <p><span style="font-size:20px;">Gladys Allen Brigham Community Center</span></p> </div> </div> </div> </div> </div> <div class="col-lg-4" > <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-6609" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p><span style="font-size:20px;">Greenagers</span></p> <p><span style="font-size:20px;">Lee Youth Association</span></p> <p><span style="font-size:20px;">Literacy Network of South Berkshire</span></p> <p><span style="font-size:20px;">Pediatric Development Center</span></p> <p><span style="font-size:20px;">Railroad Street Youth Project</span></p> <p><span style="font-size:20px;">Rites of Passage + Empowerment (R.O.P.E.)</span></p> <p><span style="font-size:20px;">Roots &amp; Dreams and Mustard Seeds</span></p> <p><span style="font-size:20px;">Roots Rising</span></p> <p><span style="font-size:20px;">Volunteers in Medicine Berkshires</span></p> </div> </div> </div> </div> </div></div> </div> </div> </div> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-6611" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p class="text-align-center"><span style="font-size:22px;"><strong>Berkshire United Way can help you find opportunities to donate your time and talent in the community!</strong></span></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--link-buttons paragraph--view-mode--default link-button"> <div class="wrapper-field-prgf-head-content-buttons" style="text-align: center"> <div class="field-prgf-head-content-buttons button" style="background: #221e1f"> <a href="https://www.volunteerberkshireuw.org/" target = "_blank">Explore our Volunteer Center</a> </div> </div> </div> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-6613" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><hr /> <h1 class="text-align-center">EMPLOYEE GIVING PLEDGE FORM</h1> <h5 class="text-align-center">Please select your pledge option and complete the form. Thank you for your support!</h5> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-6614" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-workplace-pledge-2025-26-form webform-submission-workplace-pledge-2025-26-add-form webform-submission-workplace-pledge-2025-26-paragraph-6614-form webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form" action="/taxonomy/term/58/feed" method="post" id="webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form" accept-charset="UTF-8"> <div data-drupal-selector="edit-flexbox-04" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-04"><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method">Preferred Donation Method</label> <div id="edit-preferred-donation-method" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-payroll-deduction" type="radio" id="edit-preferred-donation-method-payroll-deduction" name="preferred_donation_method" value="Payroll Deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-payroll-deduction"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-check-donation" type="radio" id="edit-preferred-donation-method-check-donation" name="preferred_donation_method" value="Check Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-check-donation"> Check Donation </label> </div> </div> </div> </div></div></div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}}}" id="edit-payroll-deduction"> <legend> <span class="fieldset-legend">PAYROLL DEDUCTION</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" data-drupal-states="{&quot;required&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}}}" id="edit-contribution-amount-per-pay-period"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-5" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10" type="radio" id="edit-contribution-amount-per-pay-period-radios-10" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20" type="radio" id="edit-contribution-amount-per-pay-period-radios-20" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25" type="radio" id="edit-contribution-amount-per-pay-period-radios-25" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50" type="radio" id="edit-contribution-amount-per-pay-period-radios-50" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-" type="radio" id="edit-contribution-amount-per-pay-period-radios-other-" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other-"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other form-no-label mb-3"> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other" name="contribution_amount_per_pay_period[other]" value="" step="any" min="1" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3" data-drupal-states="{&quot;required&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}}}" id="edit-number-of-pay-periods-for-donation"> <label>Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation-radios" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation-radios form-item-number-of-pay-periods-for-donation-radios"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-radios-1" type="radio" id="edit-number-of-pay-periods-for-donation-radios-1" name="number_of_pay_periods_for_donation[radios]" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-radios-1"> One Time </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation-radios form-item-number-of-pay-periods-for-donation-radios"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-radios-12" type="radio" id="edit-number-of-pay-periods-for-donation-radios-12" name="number_of_pay_periods_for_donation[radios]" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-radios-12"> 12 pay periods </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation-radios form-item-number-of-pay-periods-for-donation-radios"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-radios-24" type="radio" id="edit-number-of-pay-periods-for-donation-radios-24" name="number_of_pay_periods_for_donation[radios]" value="24" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-radios-24"> 24 pay periods </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation-radios form-item-number-of-pay-periods-for-donation-radios"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-radios-26" type="radio" id="edit-number-of-pay-periods-for-donation-radios-26" name="number_of_pay_periods_for_donation[radios]" value="26" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-radios-26"> 26 pay periods </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation-radios form-item-number-of-pay-periods-for-donation-radios"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-radios-52" type="radio" id="edit-number-of-pay-periods-for-donation-radios-52" name="number_of_pay_periods_for_donation[radios]" value="52" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-radios-52"> 52 pay periods </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation-radios form-item-number-of-pay-periods-for-donation-radios"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-radios-other-" type="radio" id="edit-number-of-pay-periods-for-donation-radios-other-" name="number_of_pay_periods_for_donation[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-radios-other-"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input js-form-item js-form-type-number form-type-number js-form-item-number-of-pay-periods-for-donation-other form-item-number-of-pay-periods-for-donation-other form-no-label mb-3"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-other" type="number" id="edit-number-of-pay-periods-for-donation-other" name="number_of_pay_periods_for_donation[other]" value="" step="any" min="0" placeholder="" class="form-number form-control" /> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" aria-describedby="edit-check-donation--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}}" id="edit-check-donation"> <legend> <span class="fieldset-legend">CHECK DONATION</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck">Check Amount</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck" name="amount_of_ck" value="" step="any" min="1" class="form-number form-control" /> </div> </div> <small class="description text-muted"><div id="edit-check-donation--description" data-drupal-field-elements="description" class="webform-element-description"><h6>Please make check payable to Berkshire United Way and mail in or drop off at 200 South Street, Pittsfield, MA 01201.</h6></div> </small> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-total"> <legend> <span class="fieldset-legend">TOTAL</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,total_annual_electronic_contribution"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL ANNUAL CONTRIBUTION: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn-primary form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}"><fieldset data-drupal-selector="edit-your-name" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3" id="edit-your-name--wrapper"> <legend> <span class="visually-hidden fieldset-legend">YOUR NAME</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first">First Name</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first" name="your_name[first]" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last">Last Name</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last" name="your_name[last]" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> </div><fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-your-workplace" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-your-workplace"> <legend> <span class="visually-hidden fieldset-legend">YOUR WORKPLACE</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox-06" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-06"><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-company-or-organization form-item-company-or-organization mb-3"> <label for="edit-company-or-organization">Company or Organization</label> <input data-drupal-selector="edit-company-or-organization" type="text" id="edit-company-or-organization" name="company_or_organization" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-department-if-applicable- form-item-department-if-applicable- mb-3"> <label for="edit-department-if-applicable-">Department (if applicable)</label> <input data-drupal-selector="edit-department-if-applicable-" type="text" id="edit-department-if-applicable-" name="department_if_applicable_" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-contact-information" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-contact-information"> <legend> <span class="visually-hidden fieldset-legend">CONTACT INFORMATION</span> </legend> <div class="fieldset-wrapper"> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-email" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-email"> <legend> <span class="fieldset-legend">EMAIL</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03"><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-primary-email form-item-primary-email mb-3"> <label for="edit-primary-email">Primary Email</label> <input data-drupal-selector="edit-primary-email" type="email" id="edit-primary-email" name="primary_email" value="" size="60" maxlength="254" class="form-email form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-secondary-email form-item-secondary-email mb-3"> <label for="edit-secondary-email">Secondary Email</label> <input data-drupal-selector="edit-secondary-email" type="email" id="edit-secondary-email" name="secondary_email" value="" size="60" maxlength="254" class="form-email form-control" /> </div> </div></div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-phone-number" aria-describedby="edit-phone-number--description" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-phone-number"> <legend> <span class="fieldset-legend">PHONE NUMBER</span> </legend> <div class="fieldset-wrapper"> <span class="field-prefix"><div id="edit-phone-number--description" data-drupal-field-elements="description" class="webform-element-description">Please provide at least one contact number</div> </span> <div data-drupal-selector="edit-flexbox-05" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-05"><div class="webform-flex webform-flex--1"><div class="webform-flex--container"><fieldset data-drupal-selector="edit-work-phone" id="edit-work-phone--wrapper" class="webform-telephone--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-webform-telephone webform-type-webform-telephone js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Work</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-work-phone-phone form-item-work-phone-phone form-no-label mb-3"> <label for="edit-work-phone-phone" class="visually-hidden">Phone</label> <input data-drupal-selector="edit-work-phone-phone" type="tel" id="edit-work-phone-phone" name="work_phone[phone]" value="" size="30" maxlength="128" class="form-tel form-control" /> </div> <div class="js-form-item js-form-type-number form-type-number js-form-item-work-phone-ext form-item-work-phone-ext mb-3"> <label for="edit-work-phone-ext">Ext:</label> <input data-drupal-selector="edit-work-phone-ext" type="number" id="edit-work-phone-ext" name="work_phone[ext]" value="" step="any" min="0" size="5" class="form-number form-control" /> </div> </div> </fieldset> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"><fieldset data-drupal-selector="edit-cell" id="edit-cell--wrapper" class="webform-telephone--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-webform-telephone webform-type-webform-telephone js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Cell</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-cell-phone form-item-cell-phone form-no-label mb-3"> <label for="edit-cell-phone" class="visually-hidden">Phone</label> <input data-drupal-selector="edit-cell-phone" type="tel" id="edit-cell-phone" name="cell[phone]" value="" size="30" maxlength="128" class="form-tel form-control" /> </div> </div> </fieldset> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"><fieldset data-drupal-selector="edit-home" id="edit-home--wrapper" class="webform-telephone--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-webform-telephone webform-type-webform-telephone js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Home</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-home-phone form-item-home-phone form-no-label mb-3"> <label for="edit-home-phone" class="visually-hidden">Phone</label> <input data-drupal-selector="edit-home-phone" type="tel" id="edit-home-phone" name="home[phone]" value="" size="30" maxlength="128" class="form-tel form-control" /> </div> </div> </fieldset> </div></div></div> </div> </fieldset> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}"><fieldset data-drupal-selector="edit-your-contact-information" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3" id="edit-your-contact-information--wrapper"> <legend> <span class="visually-hidden fieldset-legend">YOUR ADDRESS</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address">Home Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address" name="your_contact_information[address]" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city" name="your_contact_information[city]" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province" name="your_contact_information[state_province]" class="form-select" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}"><option value="" selected="selected">- Select -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option><option value="Alberta">Alberta</option><option value="British Columbia">British Columbia</option><option value="Manitoba">Manitoba</option><option value="New Brunswick">New Brunswick</option><option value="Newfoundland and Labrador">Newfoundland and Labrador</option><option value="Nova Scotia">Nova Scotia</option><option value="Northwest Territories">Northwest Territories</option><option value="Nunavut">Nunavut</option><option value="Ontario">Ontario</option><option value="Prince Edward Island">Prince Edward Island</option><option value="Quebec">Quebec</option><option value="Saskatchewan">Saskatchewan</option><option value="Yukon">Yukon</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;required&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" /> </div> </div></div> </div> </div> </div> </fieldset> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-designations"> <legend> <span class="fieldset-legend">DONOR INFORMATION</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-i-plan-to-retire-and-want-to-keep-in-touch form-item-i-plan-to-retire-and-want-to-keep-in-touch"> <input data-drupal-selector="edit-i-plan-to-retire-and-want-to-keep-in-touch" type="checkbox" id="edit-i-plan-to-retire-and-want-to-keep-in-touch" name="i_plan_to_retire_and_want_to_keep_in_touch" value="1" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-i-plan-to-retire-and-want-to-keep-in-touch"> I plan to retire and want to keep in touch </label> </div> <div class="js-form-item js-form-type-date form-type-date js-form-item-retirement-date form-item-retirement-date mb-3"> <label for="edit-retirement-date">Retirement Date</label> <input type="date" data-drupal-selector="edit-retirement-date" id="edit-retirement-date" name="retirement_date" value="" class="form-date form-control" /> </div> <fieldset data-drupal-selector="edit-donor-interests" id="edit-donor-interests--wrapper" class="checkboxes--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-checkboxes webform-type-checkboxes js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donor Interests</span> </legend> <div class="fieldset-wrapper"> <div id="edit-donor-interests" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-donor-interests-i-am-interested-in-learning-about-volunteer-opportunities form-item-donor-interests-i-am-interested-in-learning-about-volunteer-opportunities"> <input data-drupal-selector="edit-donor-interests-i-am-interested-in-learning-about-volunteer-opportunities" type="checkbox" id="edit-donor-interests-i-am-interested-in-learning-about-volunteer-opportunities" name="donor_interests[I am interested in learning about volunteer opportunities]" value="I am interested in learning about volunteer opportunities" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-donor-interests-i-am-interested-in-learning-about-volunteer-opportunities"> I am interested in learning about volunteer opportunities </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-donor-interests-i-am-interested-in-learning-more-about-greylock-society-membership-donations-1000-or-how-to-combine-my-gift-with-my-spouse-partner form-item-donor-interests-i-am-interested-in-learning-more-about-greylock-society-membership-donations-1000-or-how-to-combine-my-gift-with-my-spouse-partner"> <input data-drupal-selector="edit-donor-interests-i-am-interested-in-learning-more-about-greylock-society-membership-donations-1000-or-how-to-combine-my-gift-with-my-spousepartner" type="checkbox" id="edit-donor-interests-i-am-interested-in-learning-more-about-greylock-society-membership-donations-1000-or-how-to-combine-my-gift-with-my-spousepartner" name="donor_interests[I am interested in learning more about Greylock Society membership (donations $1,000+) or how to combine my gift with my spouse/partner]" value="I am interested in learning more about Greylock Society membership (donations $1,000+) or how to combine my gift with my spouse/partner" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-donor-interests-i-am-interested-in-learning-more-about-greylock-society-membership-donations-1000-or-how-to-combine-my-gift-with-my-spousepartner"> I am interested in learning more about Greylock Society membership (donations $1,000+) or how to combine my gift with my spouse/partner </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-donor-interests-i-prefer-that-my-gift-remain-anonymous form-item-donor-interests-i-prefer-that-my-gift-remain-anonymous"> <input data-drupal-selector="edit-donor-interests-i-prefer-that-my-gift-remain-anonymous" type="checkbox" id="edit-donor-interests-i-prefer-that-my-gift-remain-anonymous" name="donor_interests[I prefer that my gift remain anonymous]" value="I prefer that my gift remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-donor-interests-i-prefer-that-my-gift-remain-anonymous"> I prefer that my gift remain anonymous </label> </div> </div> </div> </fieldset> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-preferred-donor-recognition-name-s- form-item-preferred-donor-recognition-name-s- mb-3"> <label for="edit-preferred-donor-recognition-name-s-">Preferred Donor Recognition Name(s)</label> <input data-drupal-selector="edit-preferred-donor-recognition-name-s-" type="text" id="edit-preferred-donor-recognition-name-s-" name="preferred_donor_recognition_name_s_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;invisible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022donor_interests[I prefer that my gift remain anonymous]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-donor-notes form-item-donor-notes mb-3"> <label for="edit-donor-notes">Donor Notes</label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-donor-notes" id="edit-donor-notes" name="donor_notes" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-or-fund-designation" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-agency-or-fund-designation"> <legend> <span class="fieldset-legend">GIFT DESIGNATION</span> </legend> <div class="fieldset-wrapper"> <fieldset data-drupal-selector="edit-buw-fund" class="webform-has-field-prefix checkboxes--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-checkboxes webform-type-checkboxes js-form-item form-item js-form-wrapper form-wrapper mb-3" id="edit-buw-fund--wrapper"> <legend> <span class="fieldset-legend">BUW Fund</span> </legend> <div class="fieldset-wrapper"> <span class="field-prefix"><div class="description"><h5>Your donation to Berkshire United Way supports school and career readiness, mental health and well-being, and household stability efforts&nbsp;for our neighbors. You may choose where you want to designate your gift.</h5></div></span> <div id="edit-buw-fund" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-buw-fund-invest-in-all-programs-to-have-a-maximum-local-impact form-item-buw-fund-invest-in-all-programs-to-have-a-maximum-local-impact"> <input data-drupal-selector="edit-buw-fund-invest-in-all-programs-to-have-a-maximum-local-impact" type="checkbox" id="edit-buw-fund-invest-in-all-programs-to-have-a-maximum-local-impact" name="buw_fund[Invest in ALL programs to have a maximum local impact]" value="Invest in ALL programs to have a maximum local impact" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-buw-fund-invest-in-all-programs-to-have-a-maximum-local-impact"> Invest in ALL programs to have a maximum local impact </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-buw-fund-prepare-children-and-youth-for-the-future form-item-buw-fund-prepare-children-and-youth-for-the-future"> <input data-drupal-selector="edit-buw-fund-prepare-children-and-youth-for-the-future" type="checkbox" id="edit-buw-fund-prepare-children-and-youth-for-the-future" name="buw_fund[Prepare children and youth for the future]" value="Prepare children and youth for the future" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-buw-fund-prepare-children-and-youth-for-the-future"> Prepare children and youth for the future </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-buw-fund-support-well-being-in-the-community form-item-buw-fund-support-well-being-in-the-community"> <input data-drupal-selector="edit-buw-fund-support-well-being-in-the-community" type="checkbox" id="edit-buw-fund-support-well-being-in-the-community" name="buw_fund[Support well-being in the community]" value="Support well-being in the community" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-buw-fund-support-well-being-in-the-community"> Support well-being in the community </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-buw-fund-help-working-families-succeed form-item-buw-fund-help-working-families-succeed"> <input data-drupal-selector="edit-buw-fund-help-working-families-succeed" type="checkbox" id="edit-buw-fund-help-working-families-succeed" name="buw_fund[Help working families succeed]" value="Help working families succeed" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-buw-fund-help-working-families-succeed"> Help working families succeed </label> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-other-options-to-designate" class="webform-has-field-prefix checkboxes--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-checkboxes webform-type-checkboxes js-form-item form-item js-form-wrapper form-wrapper mb-3" id="edit-other-options-to-designate--wrapper"> <legend> <span class="fieldset-legend">Other options to designate</span> </legend> <div class="fieldset-wrapper"> <span class="field-prefix"><div class="description"><h5>You may designate a portion or all of your contribution to another organization.&nbsp;<strong>Minimum $52 donation.</strong></h5></div></span> <div id="edit-other-options-to-designate" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-other-options-to-designate-northern-berkshire-united-way form-item-other-options-to-designate-northern-berkshire-united-way"> <input data-drupal-selector="edit-other-options-to-designate-northern-berkshire-united-way" type="checkbox" id="edit-other-options-to-designate-northern-berkshire-united-way" name="other_options_to_designate[Northern Berkshire United Way]" value="Northern Berkshire United Way" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-other-options-to-designate-northern-berkshire-united-way"> Northern Berkshire United Way </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-other-options-to-designate-williamstown-community-chest form-item-other-options-to-designate-williamstown-community-chest"> <input data-drupal-selector="edit-other-options-to-designate-williamstown-community-chest" type="checkbox" id="edit-other-options-to-designate-williamstown-community-chest" name="other_options_to_designate[Williamstown Community Chest]" value="Williamstown Community Chest" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-other-options-to-designate-williamstown-community-chest"> Williamstown Community Chest </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-other-options-to-designate-other-501c3-organization form-item-other-options-to-designate-other-501c3-organization"> <input data-drupal-selector="edit-other-options-to-designate-other-501c3-organization" type="checkbox" id="edit-other-options-to-designate-other-501c3-organization" name="other_options_to_designate[Other 501(c)3 Organization]" value="Other 501(c)3 Organization" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-other-options-to-designate-other-501c3-organization"> Other 501(c)3 Organization </label> </div> </div> </div> </fieldset> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-to-northern-berkshire-united-way form-item-amount-to-northern-berkshire-united-way mb-3"> <label for="edit-amount-to-northern-berkshire-united-way">Amount to Northern Berkshire United Way</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-to-northern-berkshire-united-way" type="number" id="edit-amount-to-northern-berkshire-united-way" name="amount_to_northern_berkshire_united_way" value="" step="any" min="52" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022other_options_to_designate[Northern Berkshire United Way]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-to-williamstown-community-chest form-item-amount-to-williamstown-community-chest mb-3"> <label for="edit-amount-to-williamstown-community-chest">Amount to Williamstown Community Chest</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-to-williamstown-community-chest" type="number" id="edit-amount-to-williamstown-community-chest" name="amount_to_williamstown_community_chest" value="" step="any" min="52" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022other_options_to_designate[Williamstown Community Chest]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-other-501-c-3-organization-designation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022other_options_to_designate[Other 501(c)3 Organization]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-other-501-c-3-organization-designation"> <legend> <span class="fieldset-legend">Other 501(c)3 Organization Designation</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox"><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-donation form-item-amount-of-donation mb-3"> <label for="edit-amount-of-donation">Donation Amount</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-donation" type="number" id="edit-amount-of-donation" name="amount_of_donation" value="" step="any" min="52" class="form-number form-control" /> </div> </div> </div></div><div class="webform-flex webform-flex--3"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-organization form-item-name-of-organization mb-3"> <label for="edit-name-of-organization">Name of Organization</label> <input data-drupal-selector="edit-name-of-organization" type="text" id="edit-name-of-organization" name="name_of_organization" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div></div> </div> </fieldset> <div id="edit-designation-processing-fee" class="js-form-item js-form-type-item form-type-item js-form-item-designation-processing-fee form-item-designation-processing-fee mb-3"> <label>Designation processing fee</label> <small class="description text-muted"> <div id="edit-designation-processing-fee--description" class="webform-element-description">An 8.3% processing fee will apply to all designations <strong>except</strong> Northern Berkshire United Way and Williamstown Community Chest. If a charity is not a 501(c)3 or the information you provided is incomplete, we will attempt to contact you. If your designation is less than your pledge, the rest will be applied to the BUW Fund. Processing of designations is not an endorsement of any charity. <strong>Please make sure your total designation does not exceed what you pledged.</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}}}" id="edit-agreement"> <legend> <span class="fieldset-legend">AGREEMENT</span> </legend> <div class="fieldset-wrapper"> <div data-webform-terms-of-service-type="modal" class="form-type-webform-terms-of-service js-form-type-webform-terms-of-service js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-terms-of-service form-item-terms-of-service"> <input data-webform-required-error="By checking this box, I confirm my payroll deduction request." data-drupal-selector="edit-terms-of-service" type="checkbox" id="edit-terms-of-service" name="terms_of_service" value class="form-checkbox form-check-input" data-drupal-states="{&quot;required&quot;:{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}}}"> <label class="form-check-label" for="edit-terms-of-service"> <a class="webform-dialog webform-dialog-normal button">I confirm my campaign pledge</a> </label> <small class="description text-muted"> <div id="edit-terms-of-service--description" class="webform-element-description"><div id="webform-terms-of-service-terms_of_service--description" class="webform-terms-of-service-details js-hide"><div class="webform-terms-of-service-details--title">I confirm my campaign pledge</div> <div class="webform-terms-of-service-details--content">By checking this box, I confirm my payroll deduction request.</div> </div> </div> </small> </div> </div> </fieldset> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Payroll Deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;Check Donation&quot;}}]}" id="edit-actions"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn-primary form-control" data-drupal-selector="edit-actions-submit" type="submit" id="edit-actions-submit" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-2evwvxbmd-3w8ej0niqpugrirtubx-6q3jq-dndgark" type="hidden" name="form_build_id" value="form-2eVWVXbmD-3W8EJ0niqpugRiRTUbX_6q3JQ_dNDGARk" class="form-control" /> <input data-drupal-selector="edit-webform-submission-workplace-pledge-2025-26-paragraph-6614-add-form" type="hidden" name="form_id" value="webform_submission_workplace_pledge_2025_26_paragraph_6614_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/58" hreflang="en">Solid Dark Blue</a></div> Tue, 07 Oct 2025 17:54:14 +0000 gweber 1193 at https://www.berkshireunitedway.org