Fill - Free fillable Form 2019: Knox County Government PDF form

Contact Information

Community Shares

info@communitysharestn.org

1209 Euclid Avenue, Suite 201

Knoxville, Tennessee 37921



United Way of Greater Knoxville

www.uwgk.org

1301 Hannah Avenue

Knoxville, Tennessee 37921

(865) 523-9131



Community Health Charities

www.healthcharities.org

800-654-0845



Campaign Coordinator

Anthony Smith

Ph. 215-3463 Fax: 215-3242

anthony.smith@knoxcounty.org

2019

Knox County Government

Consolidated Charities Campaign



CommunityShares▪1209EuclidAvenue,Suite201▪Knoxville,TN37921▪865‐522‐1604▪info@communitysharestn.org 

CommunitySharesTennessee  CommSharesTN

HerearesomeofourMembers’Impacts



Advocatedforandpassed2019’sKatieBeckettLaw,whichprovidesTennCaretomorechildrenwith

disabilitiesandseriousmedicalneeds.



TVAwillcleanup12millionpoundsofcoalashpollutingTennessee’sriversafterfiveyearcourt

battle.



PlannedParenthood’sTennesseeActionFundwascreatedin2018toendorsepoliticalcandidates

committedtowomen’ssexualandreproductivehealth.



TennesseeNewMajorityFundestablishedtoinvestinnonprofitsworkingtoboostvoter

participationamongcommunitiesofcolor.



22,000petsthatwouldhavebeeneuthanizedhavebeenfoundlovinghomes.



CommunityShares

supportsandfunds

social,economicand

environmentaljustice.



Howdoyouwanttochangetheworld?

Community Shares’ Member Groups

Orange indicates groups that have an actual office in the greater Knoxville area.

Black bold indicates groups that serve east Tennessee but don’t have an actual office here.

*Associate members. Receive only designated gifts.



Appalachian Community Fund 11045

Black Children's Institute of TN (BCI) 11032

CISV 11013

Community Mediation Center 11061

disABILITY Resource Center (DRC) 11059

Highlander Research & Education Center* 11002

Humane Society of the TN Valley 11035

Ijams Nature Center 11053

Jubilee Community Arts 11003

Little River Watershed Association 11074

Mid-South Peace and Justice Center 11064

Mid-TN Council of the Blind 11071

NAMI-TN (Nat’l Alliance on Mental Illness) 11009

Nashville LGBT Chamber Foundation* 11078

Nashville Peace and Justice Center 11027

Oak Ridge Environmental Peace Alliance (OREPA)

11056

People For Animals 11075

Planned Parenthood of TN & North MS 11076

Radio Free Nashville 11067

Statewide Organizing for Community eMpowerment

(SOCM) 11007

Southern Alliance for Clean Energy (SACE) 11012

Tennesseans for Alternatives to the Death Penalty 11058

TN Alliance for Progress (TAP) 11060

TN Citizens for Wilderness Planning (TCWP) 11048

TN Coalition to end Domestic and Sexual Violence 11021

TN Disability Coalition 11017

TN Environmental Council (TEC) 11010

TN Health Care Campaign 11019

TN Immigrant and Refugee Rights Coalition* (TIRRC)

11065

TN Scenic Rivers Association (TSRA) 11020

Workers Interfaith Network (WIN) 11063

United Way of Greater Knoxville

GIVE  ADVOCATE  VOLUNTEER  LIVE UNITED

LIVEUNITED!



UnitedWayofGreaterKnoxvillefightsforthehealth,educationandfinancialstabilityofeverypersoninour

community.Workingwith56PartnerAgenciesproviding120programsinthefocusareasofhealth,education,

financialstabilityandbasicneedsweseektocreatelastingchangethatwillimprovelivesinourcommunity.

Togetherweareidentifyingtherootcauseofproblemsandworkingtoalleviateorpreventthembyinfluencing

communityattitudes,strengtheningnetworksandorganizations.UnitedWayofGreaterKnoxvilleactsas

convener.Withyourhelp,wewillcontinuepreservingexistingcommunityrelationshipsandforgenew

partnershipstoidentifycoreissues,helpshoulderresponsibilitiesandensurelastingchange.Tolearnmoreabout

UnitedWayofGreaterKnoxville,pleasevisitthewebsiteatwww.uwgk.orgorcallthemainline(865)523.9131.



Ways to Give to United Way



ShouldyouchoosetogivetoUnitedWay,thebestwayisbycontributingtotheCommunityCare(General)Fund

ortooneoftheFocusAreas.Trainedvolunteershaveoversiteforgrantingthesefundswheretheycanmakethe

largestlastingimpactinourcommunity.Givingherestayshere.



DesignatedGifts:Atleasta$100contributionisrequestedfordesignatedgiftsmadetoaUnitedWayofGreater

KnoxvillePartnerAgency(listedontheoppositepage)oranotherUnitedWay.Designationsarenotsubjecttothe

reviewofover200volunteersworkingtomakeinformeddecisionsaboutlocalneedsandmaynotbeappliedto

programsfundedbyUnitedWayofGreaterKnoxville’sgrantingprocesstosolvetargetedcommunityproblems.

That’swhymanydonorschoosenottodesignatetheirgift.



TodesignategiftstoaspecificUnitedWayofGreaterKnoxvillepartneragencyoranotherUnitedWayplease

accessonline

UnitedWayofGreaterKnoxville

www.uwgk.orgor865.523.9131

UNITED WAY OF GREATER KNOXVILLE CHARITY LISTING

UWGK 59936 FriendsofLiteracy 30840

FinancialStabilityFocusArea 80776

GirlScoutsoftheSouthern

Appalachians 83164

HealthFocusArea 15814 GirlTalk,Inc. 22161

EducationFocusArea 89746 GirlsIncorporatedoftheTNValley 19282

211InformationandReferral 95858 GreatSchoolsPartnership 93874

AmericanRedCross 64886 HelenRossMcNabbCenter 42742

TheArcKnoxCounty 58116 InterFaithHealthClinic 90504

BigBrothersBigSistersofEastTennessee 62454 KnoxCountyRescue 22004

BikeWalkTennessee(KnoxvilleRegion) 81857

KnoxCountySchools/PTAClothing

Center 94555

BoyScoutsGreatSmokyMountain

Council 86764 KnoxvilleAreaUrbanLeague 28553

Boys&GirlsClubsoftheTennessee

Valley 18994 KnoxvilleLeadershipFoundation 16115

BridgeRefugeeServices,Inc. 47095 LadiesofCharity 20466

CAC‐OfficeonAging 42733 LegalAidofEastTennessee 15823

CASAofEastTennessee 67097

MentalHealthAssociationofEast

Tennessee 19194

CatholicCharitiesofEastTennessee 54528 MetroDrugCoalition 22530

CatholicCharities/UTPartnership 94260 TheMuseKnoxville 22121

CentroHispanodeEastTennessee 18950 TheSalvationArmy 63052

CerebralPalsyCenter 37952

SecondHarvestFoodBankofEast

Tennessee 88047

CerebralPalsyHousingCorporation 38209

SeniorCitizensHomeAssistance

Service,Inc. 30158

ChildHelp,Inc. 65658

Shangri‐LaTherapeuticAcademyof

Riding 53629

TheChildren'sCenter 25270 SoutheasternHousingFoundation 15235

CommunityCoalitionAgainstHuman

Trafficking 81865 Susannah'sHouse 81899

DollyPartonImaginationLibraryofKnox

County 79887 ThriveLonsdale 22165

EastTennesseeChildren'sHospital

RehabilitationCenter 14068 tnAchieves 18098

EastTennesseeKidneyFoundation 39528 VolunteerMinistryCenter 14821

EmeraldCharterSchools 20798 WesleyHouseCommunityCenter 61486

EmeraldYouthFoundation 44852 WilliamsCreekYouthFoundation 93841

FamilyPromiseofKnoxville 83806 YMCAofEastTennessee 74409

TheFlorenceCrittentonAgency,Inc. 40090 YWCAKnoxville 98630

Community Health Charities is a nonprofit that raises awareness and resources for health and

wellness by connecting more than 2,000 of the most trusted health charities across the United

States with more than 17 million caring donors through workplace giving campaigns, causes,

wellness programs, employee engagement, and strategic partnerships.

For over 60 years, Community Health Charities has been delivering more of every donor dollar to

the health charities on the forefront of providing innovative research, programs, and services that

help us live healthier lives. Your donation provides resources and services to support healthier

communities, workplaces, and families.



When you give to Community Health Charities, you can choose a specific charity or combination of charities from

our member list or you can designate directly to the Community Health Charities. Designations to Community

Health Charities support the services we provide to our member charities.

Charities listed below are providing services in Tennessee. Those in BOLD have an actual Knoxville office.

B00024 CommunityHealthCharities



B02084 EpilepsyFoundationofEastTennessee

B00271 ALSAssociation,TennesseeChapter,Lookout

Mountain



B02447 HighHopes,Inc.

B00270 ALSAssociation,TennesseeChapter,Collierville



B02741 JDRFInternational,EastTennesseeChapter

B00268 ALSAssociation,TennesseeChapter,Kingsport



B02742 JDRFInternational,MiddleTennesseeChapter

B00269 ALSAssociation,Tennessee

Chapter,Louisville



B02743 JDRFInternational,WestTennesseeChapter

B00272 ALSAssociation,TennesseeChapter,Nashville



B02951 Leukemia&LymphomaSociety,Tennessee

Chapter

B00401 Alzheimer'sAssociation,TennesseeChapter,

Nashville



B03045 LupusFoundationofAmerica,Mid‐SouthChapter

B00397 Alzheimer'sAssociation,TennesseeChapter,

Knoxville



B03089 Make‐A‐WishFoundationofMiddle

Tennessee

B00434 Alzheimer'sTennessee,Inc.,Cookeville



B03172 MarchofDimes,Nashville/MiddleTennessee

B00435 Alzheimer'sTennessee,Inc.,JohnsonCity



B03268 MentalHealthAssociationofMiddleTennessee

B00436 Alzheimer'sTennessee,Inc.,Knoxville



B03282 MercyHealthServices,Inc.

B15025 Alzheimer'sTennessee,Inc.,Nashville



B03460 MuscularDystrophyAssociation,Tennessee,

Brentwood

B00598 AmericanCancer

Society,Nashville



B03459 MuscularDystrophyAssociation,Tennessee,

Memphis

B00706 AmericanDiabetesAssociation,Tennessee,

Nashville



B03598 NationalFoundationforTransplants

B00794 AmericanHeartAssociation,GreaterSoutheast

Affiliate,Tennessee,Chattanooga



B03642 NationalKidneyFoundationServingEast

Tennessee

B00795 AmericanHeartAssociation,GreaterSoutheast

Affiliate,Tennessee,Knoxville



B03644 NationalKidneyFoundation

ServingWest

Tennessee

B00796 AmericanHeartAssociation,GreaterSoutheast

Affiliate,Tennessee,Memphis



B03728 NationalMultipleSclerosisSociety,Tennessee,

Mid‐South

B00797 AmericanHeartAssociation,GreaterSoutheast

Affiliate,Tennessee,Nashville



B04378 SiloamFamilyHealthCenter

B00858 AmericanLiverFoundation,Mid‐SouthDivision



B00136 St.JudeChildren'sResearchHospital

B00926 American

LungAssociationinTennessee,

Nashville



B04547 St.JudeChildren'sResearchHospital

(servingAR,NorthernMS,WestTN)

B01083 ArthritisFoundation,SoutheastRegion,

Tennessee,Memphis



B04548 St.JudeChildren'sResearchHospital

(servingMiddle&EastTennessee)

B01084 ArthritisFoundation,SoutheastRegion,

Tennessee,Nashville



B04708 SusanG.Komen,CentralTennessee,Chattanooga

B01321 BreastCancerResearchFoundation,Inc



B04709 SusanG.Komen,CentralTennessee,Central

Tennessee

B01766 Crohn's&ColitisFoundation,TennesseeChapter



B04710 SusanG.Komen,Tennessee,EastTennessee,

Knoxville

B16981 CysticFibrosisFoundation,TennesseeKnoxville

Chapter



B04712 SusanG.Komen,Tennessee,EastTennessee,Tri‐

Cities

B01835 CysticFibrosisFoundation,

TennesseeNashville

Chapter



B04711 SusanG.Komen,Tennessee,Memphis‐MidSouth

B01836 CysticFibrosisFoundation,WestTennessee

MemphisChapter



B04761 TennesseeHemophilia&BleedingDisorders

Foundation

B01915 DownSyndromeAssociationofMiddle

Tennessee



B04762 TennesseeKidneyFoundation

B02000



EasterSealsTennessee

 

2019KNOXCOUNTYEMPLOYEES

CONSOLIDATEDCHARITIESCAMPAIGN

10/07/2019thru12/06/2019

NOTES

Pledge Form Instructions

Please read these instructions carefully

To Ensure That Your Contribution is made in the Way You Want

Make sure your full Name, Department and your Knox County Employee I.D. (Not Badge

Number) are written LEGIBLY.

STEP ONE: Choose either to payroll deduct your contribution over your 26 paychecks through

Option 1: Payroll deduction or Option 2: A one-time contribution that you pay by cash or check.

Remember, you must write SEPARATE CHECKS for each charity you contribute to. (i.e., if

you pledge $50.00 but want to designate $25.00 to United Way and $25.00 to American Cancer,

you MUST write two checks, one payable to each charity).

STEP TWO: Designate your gift—there are four charities supported in the Knox County

Consolidated Charities Campaign. You may choose to contribute to just one or all four. Please fill

in the amount you are contributing PER PAYCHECK to each charity in the box to the right of

your chosen charity (ies).

DESIGNATIONS: Both Community Health Charities and Community Shares offer designation to

specific charities from their lists. There is no minimum amount for your pledge to be honored. You

can find the specific agencies listed on their pages in this booklet. Please write the agency codes in

the boxes to the left where applicable of the organization and how much PER CHECK you wish

to donate to each one in the spaces to the right.

United Way encourages you to contribute undesignated gifts however you may designate your

donation of at least $100 per designated agency. If you are interested in designating your United

Way gift, please complete a designation form located online .

Total your designation and write that amount in the box to the right of the Total Designated

Amount. This amount should match your amount in Step One.

Sign your form and re-check all of your amounts thoroughly. Please cut off the bottom portion

below the dotted line to keep as your pledge receipt for tax purposes. Return Pledge Form to

Anthony Smith – Human Resources CCB #360.

If you have any questions please contact your employee campaign coordinator.

Anthony Smith

Ph.: 215-3463 Fax: 215-3242

anthony.smith@knoxcounty.org

2019 Knox County Employees Consolidated Charities Campaign Pledge Form

Name: Emp. # Department



Step One:

Choose your payment method.

Option 1 Payroll Deduction: I authorize $_____________ per paycheck for 26 paychecks totaling $____________ year.

Option 2 One-Time Gift: I am enclosing my total gift of $_______________ (Cash) or $ __________________ (Check)



Step Two:

Designate your gift — amount per pay check or attached cash/check

Enter Agency Code # on line below if applicable Enter ($) Amount on line below

Agency # Agency Name__________________________ $

United Way of Greater Knoxville ………………………………………..............$

***Agiftofatleast$100.00onaseparateUnitedWayformisneededtodesignatetoaspecific

UnitedWayAgency.FormsavailableOnline.

Agency # Agency Name__________________________ $

Total Designation Amount $ per check x 26 = $ _____________ yearly (Must match amount in Step 1)

Signature (Required) Date ___________________



Step Three:

Complete save and send to anthony.smith@knoxcounty.org or fax 215-3242

-----------------------------------------------------------------------------------------------------------------------------------------------------

2019 Knox County Employees Consolidated Charities Campaign Pledge Receipt — PLEASE CUT OFF AND KEEP FOR TAX PURPOSES

Name: Amount: $ _________________ Date:

**

(

SheriffDe

t.Em

ees—KnoxCount

EMP#isre

uired“Pleasedonotuse

ourBad

e#”

)



Consolidated Charities Campaign

Community Shares



United Way of Greater Knoxville



Community Health Charities

2019

Knox County Government

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