SARH Foundation Employee Giving Circle

Payroll Deduction Form
SARH Foundation's Employee Giving Circle
The SARH Foundation Employee Giving Circle consists of leadership, physicians, nurses, staff, and other employees who support the SARH Foundation through a payroll deduction. To join and become a giver, select whether you want a recurring donation deducted from each pay period or a one-time donation deducted from your next paycheck.

All gifts are tax-deductible to the extent allowable by law. For more information about the Employee Giving Circle, visit www.sarhfoundation.org.

Please complete and submit this form to sign up for the Employee Giving Circle. For more information, contact SARH Foundation Executive Director Amy Sturdivant at asturdivant@sharefoundation.com or 870-881-9015 ext. 5.

Directions:
Complete all required sections and select Recurring Donations or One-Time Donation for your payroll deduction. Be sure to specify your amount and the donation destination of your choice. Sign and submit the form. You will receive a confirmation email within a few minutes. Once you receive your confirmation email, forward it to asturdivant@sharefoundation.com for your payroll deduction to be set up. Please keep a copy of your form for your records.
Date*

MonthDayYear
Date
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recurring Donations
If you selected "Other Amount" for Recurring Donations, enter the amount you want deducted from each pay period here. $ .
One-Time Donation $ enter dollars through payroll deduction.

To make a one-time credit card donation, please visit the Foundation's website: https://sharefoundation.com/join-us/donate-now.html.
Donation Destination of my choice*
By signing and submitting this form, you are agreeing to the payroll deduction options you have selected. To end your payroll deduction, please get in touch with the SARH Foundation or your payroll office.

Forward your confirmation email to asturdivant@sharefoundation.com
for it to be submitted to payroll.
Signature*

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Thank you for joining the Employee Giving Circle!
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Payroll Deduction Form

Thank you for joining the Employee Giving Circle!