ONLINE GIVING FORM

Circle of Care Campaign Online Giving Form

HAVE QUESTIONS?

Email: wrhfoundation@wrh.on.ca
Call: 519-985-2656

All donations are tax-deductible. Payroll deduction contributions will be recognized on your T4.

RECOGNITION

All participating employees and volunteers will be listed on the Circle of Care Campaign Donor Wall. .

Supporter Circle - $52 to $499 (Starting at $2 payroll or $1 / week)
Advocate Circle - $500 to $999 (Starting at $19.24 payroll or $9.62 / week)
Friend Circle - $1,000 to $1,999 (Starting at $38.47 payroll or $19.24 / week)
Family Circle - $2,000+ (Starting at $76.93 payroll or $38.47 / week)

Just follow these SIMPLE Steps:

Step 1:

Windsor Regional Hospital staff and volunteers have the option of designating their gift to a program or service that they are passionate about.

Gift Designations:

Other:

Step 2:

Payroll Deduction Option 1:

I want to pledge an equal amount per pay period to the area/project I've selected above. I understand my deductions will begin within 2-4 weeks and this amount will be deducted until further notice.

Enter the amount you would like to deduct each pay period:

Payroll Deduction Option 2:

I want to pledge a one-time gift to the area/project I've selected above.

Enter the amount you would like to pledge as a one-time gift:

Step 3:

*Name:

Employee Number:

*Phone Number:

*Email:

*Department:

*Campus:

The Foundation publishes an honour roll of donor names. May we include your name?:

The Foundation publishes an honour roll of donor names. May we include your name?

YES!

No thanks, I wish to remain anonymous.

WRH Foundation

ONLINE GIVING FORM

Circle of Care Campaign Online Giving Form

Just follow these SIMPLE Steps:

Step 1:

Step 2:

Step 3:

We are processing your submission.
Please do not press back or refresh.

ONLINE GIVING FORM

Circle of Care Campaign Online Giving Form

Just follow these SIMPLE Steps:

Step 1:

Step 2:

Step 3:

We are processing your submission.Please do not press back or refresh.

We are processing your submission.
Please do not press back or refresh.