Associate Giving- Payroll Deduction Form

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Thank you for extending your care through We Give To Give and Dell Children's Cares! Your gift makes a difference for Ascension Seton and Dell Children's people, places, and mission. Enter your Ascension Seton or Dell Children's username to get started.

If you prefer to give via credit card, please contact Callie Atkins (callie.atkins@ascension.org)

One time or biweekly payroll deduction?

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One time

Biweekly

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One time amount deducted

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$25

$50

$150

$250

$500

Other

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Enter one time amount deducted

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Amount deducted per pay period

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$10

$25

$50

$100

Other

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Enter amount deducted per pay period

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Which fund would you like to support?

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Charity Care

Emergency Relief Endowment

Seton Nurse Scholarship Endowment

Nursing Fund for Professional Development, Scholarly Activities, and Recognition

Dell Children's Family Fund

Dell Children's Area of Greatest Need

emBark! Medical Facility Dog Program

Endowment for Dell Children's

Dell Seton at The University of Texas- Area of Greatest Need

Women First at ASMCA

Ascension Seton Williamson- Area of Greatest Need

ASW Caring for the Caregiver

Care-a-Van at ASHL (Children's Healthcare Endowment)

ASHL Seton Circle

ASNW Seton Circle

ASW Seton Circle

Caring for the Caregiver at ASB, ASEBD, ASSV, ASSW

Ascension Seton Hays- Area of Greatest Need

ASH Caring for the Caregiver

Children's Care-a-Van at ASEBD (Children's Healthcare Endowment)

ASH Seton Circle

ASSW Seton Circle

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First Name

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Middle Initial

Last Name

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Preferred Email Address

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Active Directory ID

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Home Address

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City

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State

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Zip Code

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Primary Phone Number

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Employee ID

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Work Location

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Work Location

Name of location

Are you a MOSTL (Ascension Corporate) associate?

Yes

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Date

M-D-Y

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