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Get La West Jefferson Hospital Foundation Employee Giving Pledge Form 2019-2025

Ry care at West Jefferson Medical Center, you will be recognized on the annual E-Donor Wall. Required information Employed with O WJMC O NOPS O LCMC Name Last 4 digits of SS# Department Home address City State Home phone Cell phone Zip Email Payroll deduction donation options The gift chart below shows the impact your payroll deduction gifts can make over a 26 pay period O Annual giving Total gift of $ 26 pay periods $ (deduction per paycheck) O Continued giving By signing.

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