Colleague Giving RPD - MercyOne North Iowa Foundation

Recurring Payroll Deductions

Recurring payroll deductions will begin on the first pay period of the calendar year and continue for one year (26 pay periods). Contact Josh Guyer at josh.guyer@mercyhealth.com or 8-5656 with any questions. PRN and MercyOne Central Iowa payroll colleagues are encouraged to participate through cash, check or credit card, as they are not eligible for payroll deductions.

Donation Per Pay Period

Amount:

$5.00

$10.00

$15.00

$25.00

$50.00

Choose amount per pay period

Designation:

Colleague Information

Anonymous:

I prefer to make this donation anonymously

Colleague ID:

Employer:

Personal Contact Information

Foundation will provide calendar yearend giving statement

Title:

First name:

Last name:

Country:

Address:

City:

State:

ZIP:

Phone:

Email:

Donation Form