Community Outreach – Ascension Saint Vincent's

Associate Giving Payroll Deduction

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Question - Required - I would like to contribute this amount per pay period:

   


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Question - Required - Which fund would you like your donation to support?

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Question - Required - Which campus do you primarily work at?

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  Contact Information

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Name:

 

 

 

 

       

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City/State/ZIP:

 

    

 

 

Date of Birth:

 


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