1-2-3 Giving

Cheyenne Regional is proud to introduce 1-2-3 Giving. This program offers a convenient and impactful way for our employees to donate to any area of need within our health system.

What is 1-2-3 Giving?

  1. Donate a set amount. It could be $5, $10, $25 or any whole dollar amount that fits your budget.
  2. Donate every two weeks through payroll deduction. You could also choose to donate monthly by credit card or by contributing PTO.
  3. Donate for three years.
    • You always have the option to increase, decrease or make other changes to your level and frequency of giving

The Impact of 1-2-3 Giving

Can you donate:
$5—a cup of coffee?
$10—two $5 Subway Footlongs?
$20—a meal out?
$50—a tank of gasoline?

Example: If just half of our 2,100 plus employees donated $5 per pay period to our Employee CareFund, that would generate over $136,000 per year to help Cheyenne Regional employees in need.

Create a Payroll Deduct donation

Please complete the form below to create a Payroll Deduct donation. In addition to the Employee CareFund, you may also designate “Other” areas to support (e.g., Cancer Services, Hospice Services, etc.)

1-2-3 Giving - Payroll Deduction Authorization

Name(Required)
I authorize Cheyenne Regional Medical Center to deduct the amount specified below from my check via payroll deduction.
Frequency of Deduction(Required)
Gift Designation

Signature(Required)
Address
MM slash DD slash YYYY

Note

If you have any questions regarding this form please contact Landon Brown at (307) 432-2677 or [email protected]. Cheyenne Regional Medical Center Foundation is a nonprofit charitable organization under IRS section 501(c)(3). Federal tax ID 83-0236858

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