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Grateful Giving Campaign

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Give. Hope. Inspire.

Payroll Deduction Form

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Personal Information

SELECT DESIGNATION

Invalid! Please choose a designation.

By selecting a designation below, you are giving to the greatest need unless a specific program is selected. You must select a designation.

If you would like to give only PTO hours to Close Enough to Care, click here to be directed to that form option.

Spectrum Health Grand Rapids

Helen DeVos Children's Hospital

Big Rapids Hospital

Continuing Care

Gerber Memorial

Kelsey Hospital

Lakeland Hospital

Ludington TEAM fund

Pennock

Reed City Hospital

United Hospital

Zeeland Community Hospital

Fund Added!

Specific Program

Number of hours to donate to Close Enough to Care

Add write in gift

My Gifts to Spectrum Health:

Enter amounts on the next step

Note: If you prefer, you may print this form and interoffice mail to the Foundation office.

Frequency

5th day or closest working day

Set Up Payroll Deduction

Keep your pay stub to use as your tax receipt. Payroll deductions begin in January 2020.

Please enter the amount you want to contribute each pay period. For example, if you want to contribute $2 per pay period for that specific designation, enter $2

Amount

Note: If you prefer, you may print this form and interoffice mail to the Foundation office.

100 Michigan St. NE, Grand Rapids, MI 49503

866.989.7999

The content on this website is provided for informational purposes only and is not intended as medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.