OUR Place Employee Giving - Biweekly Payroll Deduction

There is a minimum of $1/pay period for biweekly payroll contributions. New or revised biweekly payroll deductions will begin with your May 15 paycheck.

If you already have an existing biweekly donation, you do not need to fill out this form. Please contact the Philanthropy department at 207-662-2669 or development@mainehealth.org to request your t-shirt or to make any desired changes to your recurring gift. Biweekly payroll deduction donations are ongoing and will not need to be renewed next year.

Donating through biweekly payroll is not available for per diem or contract employees. If you fall into one of these categories, please consider an alternate giving method.

Once you click submit, you should get a confirmation email. If you do not get the email, your donation did not go through - please try submitting the form again. Please contact our Philanthropy Department at development@mainehealth.org or 207-662-2669 with any questions.

Donation Information

Amount:

Biweekly Payroll

$ 50.00

Biweekly Payroll

$ 20.00

Biweekly Payroll

$ 10.00

Biweekly Payroll

$ 5.00

Biweekly Payroll

$ 2.00

Biweekly Payroll

$ 1.00

Other

MaineHealth Unrestricted is the default option. Other location and designation options are listed in alphabetical order. Please make sure to select your preference if you don't want the MH default.

Additional Information

Your t-shirt will be delivered to your work location as soon as possible. In order to do so, please make sure to provide detailed work delivery location information (ex: Philanthropy, 7 Bramhall St, Portland, 2nd floor, room 306). The more detail you provide, the quicker and easier delivery will be. Unfortunately, we cannot mail to home addresses.

Donation Type:

Physical Work Address (dept., bldg, floor etc.):

T-Shirt Size:

Contact Information

Title:

First name:

Middle name:

Last name:

Country:

Address lines:

City:

State:

ZIP:

Phone:

Email: