Employee Giving Pledge Form

Employee Information


Tax acknowledgement will be sent to the address listed below

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

You can pick many programs as you wish 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

$ / pay period

Recurring Pay Periods

B. 2021 commitment

Donation per pay period x 26 pay periods

$ / pay period

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.

Total Amount



Please enter your full name below to confirm your participation in the program: *

Thank you for your pledge!

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]