2026 Staff Giving Webform You must have JavaScript enabled to use this form. I believe all individuals should have the opportunity to participate in the life-changing programs at the Y and want to support the Y’s 2026 Impact Fund with a gift of: Donor Information Name Date of Birth Address Address Address 2 City State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Phone Email Member ID If you don't know your SGA Member ID, you can log into SGA Pulse and search for your account by name. Your Member ID will be the account number next to your name. Example: 1154084 Please recognize my gift as I prefer to remain anonymous My gift will support the location selected below: - Select -Albemarle Family YMCABlocker Norfolk Family YMCACurrituck Family YMCAEastern Shore Family YMCAEffingham Street Family YMCAGreat Bridge/Hickory Family YMCAGreenbrier Family YMCAGreenbrier North YMCAFirst Tee — Hampton RoadsHilltop Family YMCAIndian River Family YMCAJames L. Camp Jr. Family YMCAMt. Trashmore Family YMCANorthampton County YMCAOuter Banks Family YMCAPrincess Anne Family YMCASuffolk Family YMCATaylor Bend Family YMCAYMCA at EdinburghYMCA at JT's Camp GromYMCA Camp Silver BeachYMCA of PortsmouthYMCA of South Boston/Halifax CountyYMCA on GranbyYMCA of South Hampton Roads Home OfficeI would like my gift to support more than one location. I would like my gift to equally support the following locations Albemarle Family YMCA Blocker Norfolk Family YMCA Currituck Family YMCA Eastern Shore Family YMCA Effingham Street Family YMCA First Tee — Hampton Roads Great Bridge/Hickory Family YMCA Greenbrier Family YMCA Hilltop Family YMCA Indian River Family YMCa James L. Camp Jr. Family YMCA Mt. Trashmore Family YMCA Northampton County YMCA Outer Banks Family YMCA Princess Anne Family YMCA Suffolk Family YMCA Taylor Bend Family YMCA YMCA at Edinburgh YMCA at JT's Camp Grom YMCA Camp Silver Beach YMCA of Portsmouth YMCA of South Boston/Halifax County YMCA of South Hampton Roads YMCA on Granby Payment Options Payment Options - Select -I wish to make a recurring gift through payroll deductionI'll make my gift through another payment method. Amount deducted per paycheck Please enter the amount you wish to have deducted each time you get paid. There are 26 pay periods in 2026. Example: If you're making a gift of $260, your amount per pay period would be $10. I authorize ongoing deductions from my paycheck until I notify the YMCA to cancel my contributions. When you check the box to authorize ongoing contributions, your amount deducted per pay period will continue even after 2026 ends, until you make a change or request to end your ongoing gift by contacting the Financial Development team. If you would like your gift to end at the end of 2026, please uncheck the box. Payment Information Send Reminder Reminder Frequency - Select -One TimeQuarterly Reminder Month - Select -JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Draft my account on file Last 4 digits of card on file Payment Frequency - Select -One-TimeBi-WeeklyMonthlyQuarterly One-Time Date Bi-weekly Start Date Monthly Start Date Quarterly Start Date I'll call (757) 275-9433 to pay with a new credit card I'll pay by check Additional Information I've included the Y in my estate plans. Please send me information about including the Y in my estate plans. Signature By signing below and clicking submit, I agree to donate the amount entered to support the Y's Impact Fund.
