OUR Place Employee Giving - One-Time Payroll Deduction

A minimum donation of $5 is required to give a one-time gift through payroll. Gifts of $10 or more will receive an OUR Place Employee Giving T-shirt. Your gift will be deducted from your May 15 paycheck.

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:

One-Time Payroll

$ 100.00

One-Time Payroll

$ 50.00

One-Time Payroll

$ 25.00

One-Time Payroll (minimum to receive t-shirt)

$ 10.00

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.

Full Work Location (dept, address, bldg, fl, etc.):

Donation Type:

T-Shirt Size:

Contact Information

Title:

First name:

Middle name:

Last name:

Country:

Address lines:

City:

State:

ZIP:

Phone:

Email: