Employee Giving

THANK YOU for partnering with us in our mission of Healing, Teaching and Preaching by making a payroll donation to our NEA Baptist Charitable Foundation. Your generosity enables us to to provide much needed medical care, patient assistance, grief counseling, employee emergency assistance, medical enhancements, continuing education for our medical staff and much more. All funds raised are used to benefit our Northeast Arkansas community.

Please choose one(Required)

New Employee/Donor

Current Employee/Donor

Choose your selection below- New Employee/Donor Options(Required)

Payroll Deduction (per pay period - specify amount below)

One Time Payroll Deduction (specify amount below)

Choose your selection below(Required)

Payroll Deduction (per pay period - specify amount below)

One Time Payroll Deduction (specify amount below)

PTO Deduction (one time - specify amount below)

Change to Current Payroll Deduction

Cancel Payroll Giving

Payroll Deduction

amount to be deducted per pay period

One Time Payroll Deduction

amount to be deducted from a single pay period

PTO Donation

# of hours to be deducted from a single pay period

Change to Current Payroll Deduction

Please specify what change(s) to apply to your current payroll deduction

Please select your gift designation(s) - up to 3(Required)

Employee Information

Employee #(Required)

Found on the back of the NEA Baptist ID Badge

Name(Required)

First Last

Title(Required)

Example: Mr, Mrs, Ms, Dr

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Department I work in(Required)

By submitting this form you authorize Baptist Memorial Health Care Foundation to payroll deduct your selection and agree to the following:
Recurring (Per Pay Period) deductions will continue unless otherwise specified in writing and submitted the NEA Baptist Charitable Foundation.

Personal Time Off (PTO) hours will be deducted from current available balance. The cash value (number of hours x hourly rate of pay minus taxes) will be the amount donated.

Once donated these PTO hours are no longer available for personal use and 40 hours of PTO must be maintained to make the donation valid.

All personal information is confidential.

The NEA Baptist Charitable Foundation does not provide goods or services as whole or partial consideration for any contribution.

Employee Giving Form