2012 Employee Giving Donation Form

Choose one of the following options to make your donation:

Payroll Deduction

Have a set amount deducted from each paycheck. Deductions begin with the July 5 paycheck and continue for one year (26 pay periods). Give with a payroll deduction »  

Hour Club—Payroll Deduction

Become a member of the Hour Club by having your hourly pay rate deducted from each paycheck.
Join the Hour Club with payroll deduction »

Paid Leave Donation

Paid leave donations will be deducted from your paid leave bank in one lump sum in January 2013. You must leave at least 40 hours in your bank. All taxes and withholdings will be deducted from your donation, meaning there will be no impact to your take-home pay. Give with a paid leave donation »

Hour Club—Paid Leave Donation

Become a member of the Hour Club by donating at least 26 hours of paid leave. Paid leave donations will be deducted from your paid leave bank in one lump sum in January 2013. You must leave at least 40 hours in your bank. All taxes and withholdings will be deducted from your donation, meaning there will be no impact to your take-home pay. Join the Hour Club with paid leave donation »

Charge to a Credit Card

Online gifts may be charged to your VISA, MasterCard, American Express, Discover Card or PayPal account.
Give with your credit card »

Cash or Check

If you would like to donate with cash or check or if you simply prefer to use a paper form, please print and complete this pledge form PDF and return it to Fund Development (white routing slip). We do not recommend sending cash through interoffice mail.

 

Privacy Policy
 

Carle Foundation Hospital, Carle Foundation Physician Services and Carle Physician Group contract with insurance providers separately and may or may not choose to participate in all of the same insurance plans. Patients are urged to check with their carriers as to whether services are covered for either or both organizations.

Get in touch with Carle

611 W. Park Street
Urbana, Illinois 61801
(217) 383-3311

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