Donate by Payroll Deduction (Giving Hands)

First

Last

Department

Your department name

Employee Number

Your Employee Number

Phone Number

Your phone number

Email Address

Address

Address 2

City/Town

ZIP/Postal Code

Payroll Deduction Amount - Minimum $2 per pay period

Payroll Deduction Amount – Minimum $2 per pay period

I would like to designate my tax-deductible gift to:

The Greatest Need

Cardiovascular & Stroke Care

Orthopaedics

Beebe Center for Breast Health

Oncology Services

Emergency Dept. Services

Margaret H. Rollins School of Nursing

Community Health & Wellness

R. Randall Rollins Ctr. for Medical Education

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