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Employee Payroll Deduction Form
You can give a little with each paycheck!
Apply for Employee Payroll Deduction
Employee Number*
First Name*
Last Name*
Email Address*
Confirm Email*
Street Address
City
Postal Code
Phone Number
Deduction amount per pay?
For how many pay periods?
Pledge total?
Select a payment option
Option A: I authorize an ongoing deduction each pay, until I give further notice.
Option B: I authorize an amount for a number of pays (e.g. $5 x 26 pays = $130 Pledge Total)
Option C: I authorize a one-time gift to be deducted
Designate gift to this area of HHS
Select one...
Area of Greatest Need
Equipment Fund
Family Grants
Juravinski Cancer Centre
Juravinski Hospital
Hamilton General Hospital
McMaster Children's Hospital
McMaster University Medical Centre
Research
St. Peter's Hospital
Any specific program?
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