2025-2026 Annual Employee Giving Campaign

Thank you for choosing to donate to the 2025-2026 Annual Employee Giving Campaign. To make a gift via payroll deduction, please fill out the form below.

Payroll Deduction Form

First Name*
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Last Name*
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Employee ID*
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Department
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Email*
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Phone
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Select How You Want to Give*
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Enter One-Time Amount
One-Time amount to be taken on the first pay of July.
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Select Bi-Weekly Amount
I authorize UPMC Washington to deduct the selected amount below for 26 pay periods, to begin with the first pay of July.
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Enter Bi-Weekly Amount
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Per Year Amount
$0.00
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Gift for all employees who pledge $10/pay-period or more (or a flat fee of $260 and above).
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Any employee who pledges $10/pay ($260 and above) will receive a WHS t-shirt. Please indicate color and size.

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Color selection
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Color selection
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Select Location
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The names of the Employees who participate in the Washington Health System Foundation Giving Campaign will be published.*
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By signing this form above and submitting, I authorize UPMC Washington to deduct the selected amount and frequency from my payroll beginning with the first pay of July.
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Submit