Testing 2026 Unity Campaign Application webform | United Way of the Eastern Panhandle

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The below webform has been prepopulated with custom/random test data. When submitted, this information will still be saved and/or sent to designated recipients.

Organization Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Mailing Address (if different)

Agency Phone

Organization Mission Statement

Impact Area

Primary Contact's Information

Primary Contact's First Name

Primary Contact's Last Name

Primary Contact's Phone

Primary Contact's Email Address

First

Last

CEO or Executive Director Phone

CEO or Executive Director Email

First

Last

Board Chair Phone

Board Chair Email Address

Organization Information

Organization's Primary Client Needs

Which Eastern Panhandle counties does the organization serve? (select all that apply)

Berkeley

Jefferson

Morgan

Has your organization filed an IRS Form 990 within the last 18 months?

If no, explain.

Upload Copy of 501(c)(3) Tax Exemption Letter from the IRS

upload_copy_of_501_c_3_tax_exemption_letter_from_the_irs.pptx

Schools and government agencies: To bypass the field, please submit a signed letter stating that your organization is a school or government agency.
One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

What is the date of your organization's most recent registration filed with the West Virginia Secretary of State?

Logo

logo.jpeg

One file only.
200 MB limit.
Allowed types: gif, jpg, jpeg, png.

Project Information

Project Name

Project Type

Complete the following statement: "Dollars raised during the 2026 Unity Campaign will be used for..."

Unity Campaign Goal - Total number of dollars that you plan to raise through your organization's participation in the Unity Campaign.

Client Impact Story

Photo Supporting Client Impact Story

photo_supporting_client_impact_story.jpeg

One file only.
200 MB limit.
Allowed types: gif, jpg, jpeg, png.

Photo Description

List the total number of unique clients that you expect to serve with Unity Campaign funding.

Terms and Commitment

I agree to the 2026 Unity Campaign Eligibility Criteria and Guidelines.

I agree to the 2026 Unity Campaign Fundraising Policies and Guidelines.

Signature

Sign above