Employee Giving

A GUIDE FOR GIVING thru Payroll Deduction or Direct Donation
It's easy! You can donate thru payroll deduction or by making a direct donation. Following is a guide to help you decide your level of giving and a brief description of the 2018 Funds. You can select up to two funds for your payroll deduction.

PAYROLL DEDUCTION
COMPLETE FORM BELOW

DIRECT DONATION FOR 2018 FUNDS

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Cancer Patient Assist Fund - provides aid to cancer patients to ensure they have needed resources.

Cancer Services Fund - equipment, technology and cancer services that advance care for patients.

Childrens Fund - supports the advancement and growth of obstetrics and pediatric programs.

Employee Relief Fund - provide assistance to employees who have experienced a crisis.

Heart Fund - programs, equipment and facilities to advance cardio services

Patient Medication Assistance - provides limited short-term medication assistance for disadvantaged patients.

Scholarship Fund - provides scholarships to St. Mary's employees and students pursuing health care education.

Unrestricted/Greatest Need - responds to the Hospital's most urgent needs.

PAYROLL DEDUCTION FORM

Complete the form to participate in the Employee Giving Campaign thru payroll deduction. 100% of your tax deductible donation will be applied towards the fund(s) of your choice.

* Indicates required field

Name *

First

Last

ADDRESS *

CITY *

STATE *

ZIP *

PHONE/EXT *

EMPLOYEE ID *

Payroll deduction for 12 months/26 pay periods starting August 11, 2017. Indicate below the amount you want deducted per pay period.

DONATION AMOUNT *

Please apply my gift to the following fund.

Signature (type name) *

Submit