Pledge Form (2)

Employee Information


Step 1: Choose the program(s) you want to support

STEP 2: Tell us how much and how many installments

Your donation amount will be split evenly amongst all the programs you select to support.

A. Ongoing deduction (Recurring pay periods)

Recurring Donation per pay period
Recurring Pay Periods

B. 1-year commitment

Donation per pay period x 26 pay periods
26 Pay Periods

C. One-time deduction

Donation per pay period x 1 pay period
1 Pay Period


If you selected option A, recurring payments, the total amount is the dollar amount per pay period that will be deducted and does not reflect the total donation you will make.


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.