Payroll Deduction Payroll Deduction Form YES, I want to support Together, We Care! First Name:(Required) Last Name:(Required) Department:(Required) Home Address:(Required) City(Required) Postal Code:(Required) Email:(Required) Phone:(Required) I authorize GGH to deduct from my paycheque: (Please choose one amount)(Required) $5/pay $10/pay $15/pay $20/pay $25/pay I authorize GGH to deduct from my paycheque: (Please choose one amount)(Required) 1 year 2 years 3 years Until I give notice to stop Recognition(Required) Please do not recognize my gift publicly I give permision for my gift to be recognized publicly
