Donation Form

Employee Contribution Form

Please fill out this form and hit submit to make a donation. For any questions, please call 773-293-5121 or email schfoundation@schosp.org.
Contact Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number
Department*
Employee ID
Donation Information

You can make a donation via check, credit card, payroll deduction, or PTO donation.
I would like to make a donation to*
Select a program you would like your donation to support. If you do not have a preference, please select Area of Greatest Need.
Any special notes regarding this donation. For Gala raffle baskets, please include basket name and number of tickets requested.
My gift is in memory/in honor of:
I would like to make a donation via:*

Check: I have enclosed a check made payable to Swedish Hospital FoundationCredit Card: I will complete the credit card information below to charge my card.Payroll Deduction: I will complete the information for payroll deduction (one-time, per pay period until a $ is realized, or indefinitely)PTO Donation: I will identify the amount of PTO hours to donate at 100% (please include an additional 30% to cover taxes)
Credit Card Donation

Payroll Deduction

Please select one of the following options to deduct a one-time donation, deduct a set amount per pay period until a total amount is realized, or deduct a set amount per pay period with no end date.
Option 1: Please deduct $amount as a one-time donation.
Option 2: Please deduct $ amount per pay period until a total donation amount of $total amount is realized.
Option 3: Please deduct $ amount per pay period indefinitely.
PTO Donation
I would like to donate number hours of PTO at 100% (please include an additional 30% to cover taxes).
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Employee Contribution Form