Associate Giving Pledge I would like to donate the following hours of PTO:*When would you like your Paid TIme Off to be deducted?*May 2018November 2018May 2018 and November 2018 (Donated hours are deducted both in May and November)Gift Designation - Please designate my gift to:Associate Compassion FundCancer CareCardiac CareOrganizational InitiativesPatient Compassion FundUnited WayGift Recognition*I agree to my name being included in all recognition.Please make my gift anonymous. (You will not be listed in any recognition.)Name* Mr.Mrs.Ms.Dr. Prefix First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BirthdateAssociate ID #*Email We will send you an email confirmation of your gift.