Please mail this completed form to: Pennsylvania Health Law Project. 123 Chestnut Street, Suite 400.To submit your request, please fill out the form below, remembering: All requests for donations must be submitted online, 4 to 6 weeks prior to the event. Please fill out this form completely when sending deposits of donations or payments to United Charitable for your program. Add your donation form link and a creative request to donate to the email signature that appears at the bottom of all outgoing emails you send. Please mail this form with your giP to: Giving Op1ons. Payroll DeducAon. Department. Phone. If you'd rather mail in your donation with a check, please complete the Mail-In Form. 1. Verify donor section. Fill out Part B Completely. 2.