Debit Card Application Form
Information for the Recipient
- The debit card will be issued in your name.
- It can be used for purchases at retail locations and online where debit cards are accepted and can be used for employment, education, or transportation-related goals.
- It cannot be used for cash withdrawals.
- A brief survey will be required later to describe how the card helped you.
- Keep the card in a safe place at all times—either in your possession or in a secure location at home.
- Avoid giving the card to others to prevent loss or theft unless you rely on a trusted individual for purchases.
- The card is a VISA prepaid debit card issued by a bank in partnership with a debit card provider.
- The card includes benefits that VISA offers for prepaid debit cards; more details will be provided upon receipt.
- By signing, you authorize United Way of Greater Kansas City to issue a prepaid debit card in your name for household expenses or personal goals.
- You grant United Way and its evaluation partner permission to contact you via text for an evaluation survey.
- Your personal information will only be used for issuing the card and follow-up surveys and will not be sold or shared with third parties.