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TEAMgive Form
Annual TEAMember Giving Campaign
February 5-16
Annual TEAMember Giving Campaign Donation Form
Name
*
Email Address
*
Street Address
*
City
State
ZIP / Postal Code
Donation Status
*
I'm a new TEAMember
I'm a new donor
I'm a current donor and want to increase my donation
Donation Amount
I pledge to increase my payroll deduction, beginning with the next pay period:
$1
$3
$5
$10
$25
Other
Other Amount
Please increase my donation automatically by 5% next year
Please send me information on including Tabitha in my will or estate plan.
PTO
I'm interested in donating PTO hours
Number of PTO Hours to Donate
I request that the following number of hours from my Paid Time Off (PTO) balance be paid directly to Tabitha rather than to me. By completing this form, I acknowldege that I understand that I am responsible for paying the applicable taxes on the wages for these PTO hours.
Please type your first and last name to acknowledge the terms above.
*
Signature
Verification
*
By checking this box, I verify that the information is accurate and I agree to the terms listed above.
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