2024 Employee Giving Payroll Deduction Form SLCH Employees - St. Louis Children's Hospital Foundation

2024 St. Louis Children's Hospital Employee Giving Payroll Deduction Form

This form is ONLY to pick up apparel from the St. Louis Children's Hospital Foundation Office. If you wish to purchase at St. Louis Children's Hospital Coffee & Gift Shop, please complete the form at their register.

Contact Information


*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
	Phone Number:
	Yes, I would like to receive communications from St. Louis Children's Hospital Foundation.
	Yes, I would like to receive postal mail from St. Louis Children's Hospital Foundation

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Question - Required - Employee ID# (10 digit # located on the back of your badge):

*

Question - Required - Title:

*

Question - Required - Department:

Question - Not Required - Other Department:

*

Question - Required - Facility where employee works:

Question - Not Required - Other facility:

*

Question - Required - How I want to Give: (Note: You can contact the Foundation at any time to stop the deduction.)

*

Question - Required - Payroll Deduction Gift Amount: ($26 = t-shirt, $52 = sweatshirt, $78 = sweatshirt and t-shirt)

St. Louis Cardinals Incentive

Employees who donate a minimum of $10 per pay period or a one-time donation of $250 to the 2024 Employee Giving campaign by August 1 will be entered to win sets of two all-inclusive St. Louis Cardinals tickets in the BJC suite. Winners will be contacted one month before the game.

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Question - Required - Please direct my gift to:

Question - Not Required - Other gift designation:

*

Question - Required - T-shirt Size: (Unisex sizing)

Question - Not Required - Sweatshirt size: (Unisex sizing. Your one-time donation of $52 or $2 per pay period qualifies you for a sweatshirt. Please note, to receive both spirit t-shirt and sweatshirt you must make a minimum donation of $78 or $3 per pay period.)

How will I receive my apparel?

Please visit the Foundation office located at 1001 Highlands Plaza Dr. West, Suite 160, St. Louis, MO 63110. The office is open Monday–Friday from 8:30 a.m.–4:30 p.m.
Employees at Children's Specialty Care Center locations will receive their shirts via campus mail.