Employee Giving Program

Giving that comes from the heart.

If each of us give a little, collectively we can do a lot for our patients and co-workers who need a helping hand.

Your gift will ensure patients have resources that are provided nowhere else in our region. YOU are making an impact today!

As our way of saying THANK YOU for your donation of $5 or more, you will receive your choice of a Snackle Box or Rubbert Tote as our gift to you! Already a donor, increase by $3 or more and you also receive one of these gifts!

PLUS, you will automatically be entered into a monthly drawing (8 winners each month) for gift cards AND year-end drawings for amazing GRAND PRIZES!

Sign up below and you are automatically entered in monthly and year-end prize drawings! All gifts are tax-deductible and a tax receipt will be sent to you each year at calendar end.

CoxHealth Employee Giving Program

"*" indicates required fields

New or Existing Donor?*

I am a new donor

I am an existing donor

Please let us know how you heard about the program:*

Connect Daily

Orientation

Co-Worker

Computer Screensaver

E-Blast

Direct Mail

Other

Existing Donor Upgrade - Sign Me Up For:

Thank you for being an Employee Donor. Your gift has changed lives and improved community health. You are an important part of our donor family and we appreciate how you have empowered people back to good health by being a donor.

To upgrade your gift please select the amount you would like to add to your current gift in the box below.

Increase your payroll gift by at least $3 and receive the gift at your new level.

Increase your gift by a minimum of $3 and receive a CoxHealth gift!

To qualify for the $3 minimum upgrade, you must already be an employee donor for 120 days.

Donation Amount Per Pay Period

Additional Donation Amount Per Pay Period

Other Donation Amount Per Pay Period

New Employee Donor - Sign Me Up For:

One-Time Donation Amount

Donation Amount Per Pay Period

Other Donation Amount Per Pay Period

Contact Information

Name*

First Last

Employee ID Number*

Location*

Ex: North, South

Home Address*

Street Address City ZIP Code

Cell Phone*

Email*

I work in Department*

Work Phone*

Authorization

I authorize a payroll deduction from my CoxHealth paycheck as a charitable contribution. I understand that the amount I selected above will be deducted from my paycheck each pay period with automatic renewal. Cancellation will require 120 days minimum participation.