Employee Giving "*" indicates required fields 1Your Donation2Your Information3Finalization Your DonationChoose Your Payroll Deduction Amount*Donations may also be scheduled monthly, quarterly, or annually. Please use "Other" option and provide your donation amount and frequency preference. $5 per pay period $10 per pay period $20 per pay period $40 per pay period $80 per pay period Other Choose the Length of Your Commitment* Ongoing (Never worry about signing up again. Contact the Development Manager to change your contribution level at any time.) 26 pay periods (One full year of pay checks) Start Date* Your InformationName* First Last Employee ID Number*5 digit number used to print/clock inDepartment*Email* Phone Number*Street Address*Address Line 2City*State*Zip Code* How would you like your name listed in recognition materials?*Your enrollment qualifies you as a Partner In Potential. This community of monthly donors is recognized on an annual basis as sustainers of our mission in materials such as our Annual Report.CommentsAgree to Terms and Conditions* I authorize this post-tax payroll deduction in the amount indicated per pay period as my gift to Clearbrook. I understand that my contribution is voluntary and that at any time I can adjust or cancel my contribution by emailing employeegiving@clearbrook.org.
