Employee Giving Donation Form

Yes! I want to make a difference and support programs that help people locally.

Every gift of every amount makes a difference! 100% of your donation supports the cause!

* indicates required field

• Employee First name: *
• Employee Last name: *
• Employee Number: *
• Email: *
• Choose the entity where you work: * -Select Entity- Aspirus Wausau Hospital Aspirus Inc Aspirus Clinics Aspirus At Home

Donation Details

I WOULD LIKE TO MAKE A GIFT OF: * $.00

Payment Method

If you choose to make your payment via payroll deduction you will have the option on the next step to choose to make your payment as a one-time deduction or smaller deductions per pay period. If you plan on choosing the per-pay period option, please make a minimum gift of $52.

I would like to make my gift via the convenience of: * Payroll DeductionCredit Card

Additional Details

I would like to make my tax-deductible gift to the area I am most passionate about: * Family House at Aspirus
Greatest Needs and Community Health Initiatives
Other

Optional Details

This gift is in: Honor OfMemory Of

Name of Person (if applicable):

Would you like us to send notification of your gift to anyone? YesNo

Check here if you wish for your donation to remain anonymous: I wish to remain anonymous.