* Please provide an email address that you check often so that we can contact you with any questions about your donation.
*Please check in with the Foundation as the event gets closer to pick up your tickets.
*By indicating a payroll deduction option, you authorize the IMH Accounting department to process your payment. If you choose to terminate employment prior to fulfilling your pledge it can be completed from your last check.
As a thank you for participating in the employee campaign.
We will also enter your name to win one of raffle prizes below. Please enter the total number of raffle tickets that you want entered for each raffle item.