Payroll Deduction Enrollment – for Pledged Gifts Payroll deduction is an excellent way to support your hospital! Your giving total will appear on your T4 at year-end. You may change your amount at anytime. Employee InformationName* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Email Home PhoneHospital Email* Hospital Extension* Bi-weekly Payroll Deduction DonationPayroll Deduction* Yes! Please register me for payroll deductions. Total Amount of Pledge:Bi-Weekly Payroll Deduction Amount*Date to Commence* MM slash DD slash YYYY Recognition Information*please selectPlease include recognition as followsPlease enter name as you would like it to appear on all recognition material*
