Employee Giving Donation Via Payroll Deduction

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!

You've selected to give your donation via employee payroll deduction.

* 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 Post-Acute Care

Amount of my Gift

Total amount of my gift:* $25
$52 ($2 per pay period)
$78 ($3 per pay period)
$104 ($4 per pay period)
$260 ($10 per pay period)
Other

Gift Designation through Aspirus Health Foundation

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

Payroll Options

Please indicate your preference as to how you want the total amount of your gift deducted: * One-time deduction (full amount to be deducted the first pay period in May 2021)
Divided equally each pay period over 12 months beginning with the first applicable pay period in May 2021 and continuing through April 30, 2022 (minimum $52 gift).
Continue my pledge until I notify you in writing

Recognition Details (Optional)

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.