QC Dividend Enrollment

Participant Information

• Company Name: List the company as you wish it to appear on official communications or publicity.
• CEO/Primary Contact: Please provide the name of the CEO or the person who should be contacted for information about Dividend participation and the company’s giving practices (if different from the chief executive).
• Communication Contact: Please provide the name of the staff member who oversees the company’s external and internal communication efforts.

Recognition Qualifications

Based on your calculations, select either 1%, 3% or 5% giving. A giving percentage greater than 1% but less than 3% should be listed as 1%, a giving percent of greater than 3% but less than 5% should be listed as 3%; a giving percent over 5% should be listed as 5%.

A Giving Level Worksheet is provided to help determine your percentage of giving.

(This is for your use only. Please do not return it to us.)

• Contributions can be made to charities, projects and organizations generally listed under the IRS Code Section 501(c)3 or equivalent charitable purposes.
• The percentage target for corporations is based on domestic, pre-tax net earnings from the company’s income statement. If the company calculates earnings by location, you may use local pre-tax earnings for this purpose.
• A rolling three-year average may be used for firms with wide swings in their business cycle as long as this method is consistently applied. Companies in certain industries, such as banks, insurance companies, utilities and branches of divisions of national companies doing business in the QC, may use customary business accounting methods to achieve the one, three or five percent target.
• Contributions by affiliated foundations, whose major asset is the company’s stock, are eligible.
• For closely held businesses, service corporations and partnerships, a combination of personal and business contributions is allowed.
• As a general rule, combined giving should be the equivalent of one percent or more of pre-tax earnings before deducting the principal owner’s salary or partnership salaries and distributions.
• Companies wishing to include employee volunteerism as in-kind contribution may do so to the degree that the company is giving away something of value. Employee volunteerism hours that qualify should:
  • Be calculated based on volunteer work that is conducted on the company’s time.
  • Be calculated using actual cost or using the national average hourly rate of $31.80. (source: Independent Sector, Do Good Institute.)

Organization Profile

Select the boxes in each section that best describes your organization.

Voluntary Contribution

Participation in the QC Dividend Program is free of charge. The program is operated by the United Way Quad Cities. If you would like to make a voluntary contribution to the QC Dividend Program to help offset the program and operating costs, you may do so upon completion of your enrollment form, or by clicking here. Your contribution is tax-deductible and counts toward Dividend qualification.

Click here for the Giving Level Worksheet.