Pledge Form (2)

Employee Information

City
State/Province
Zip/Postal

STEP 1: I’d like to support the following program:

You can enter an amount for as many programs as you wish to support.

STEP 2: Tell us how much and how many installments

You can enter an amount for as many programs as you wish to support.

Recurring Donation

26 Pay Periods

One-Time Donation

1 Pay Period

TOTAL DONATION AMOUNT

Your total donation amount.

Acknowledgement

Your contributions are tax deductible to the extent permitted by law. Tax ID # 95-2810095

There are no reimbursements once a deduction has been taken.

Note: Payroll deductions will always start with the beginning of a new pay period.

For all program inquiries, changes to pledge amounts or cancellation of pledge please email the Development Department at [email protected] 


AltaMed GIVES empowers our over 2,500 employees to harness the power of their tax-deductible contributions and volunteer efforts to benefit the patients we serve. Participating in this employee-led program is easy – employees can make either a one-time monetary donation or select to make automatic payroll deductions via AltaMed’s payroll system. Here’s the fun part: YOU get to decide which programs, services and activities we support!  By coming together with your fellow employees to support our community, we can make a difference in the lives of the patients we serve.