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Please Fill Out the Payroll Deduction Form Below 

 

Prefix
First Name *
Last Name *
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Country
Address Line 1 *
City *
State/Province *
Postal Code *
Fair Share= 1 hour pay per month, Fair Share Plus= 1% of annual income, Marquis Society = $1,000 total
Number of Pay Periods
Designation
By selecting one of these options, you are stating that you want your donation to go to this specific designation area. By not selecting anything, your donation will automatically go to the Community Care Fund.