I’d like to participate by:*

Payroll deduction

PTO donation

One-time gift

My Investment

Continue my current payroll gift

$2 per paycheck ($52 annually)

$5 per paycheck ($130 annually)

$10 per paycheck ($260 annually)

Other

Other amount per paycheck ($)

PTO Donation

Foundation staff will contact you with details.

I would like to donate ___ hours of PTO.

One-time Gift

Amount ($)

Payment Method

Cash

Check

Give Online

Associate Name*

Associate Number*

Signature*

Date*

I would like my gift to be anonymous.