PayrollDeduction

Encompass Cares

Payroll Deduction Donation Form

Name*
Address*
City*
State*		Zip*
Phone*
Email*
Encompass Branch*
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I wish to donate the following number of days* compensation to Encompass Cares:
	1 Day of Compensation 2 Days of Compensation 3 Days of Compensation 4 Days of Compensation 5 Days of Compensation Other Amount	Other amount (in dollars)
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Please payroll deduct my gift accordingly:
	One-time gift Over 6 months Over 12 months
* Calculation is based upon the average daily rate earned during the first half of 2009.
Please click the button below. Encompass Cares is grateful for your donation. Thank you for answering the call to give to those in need. The Encompass Cares mission is "A Better Way to Care... to Serve and Give." Your support makes this mission possible.

* Required