About Your Gift Schedule One-Time Payroll Deduction Bi-Weekly Payroll Deduction Biweekly $5 $10 $15 $20 $40 Other Biweekly Other One Time Payroll $25 $100 $250 $500 $1000 Other One Time Payroll Other First Name * Last Name * Email Address * Phone * Gift in Honor My Gift is in honor of someone Payroll deduction will continue until you request cancellation from the Foundation. Contact 424.338.8686 About your Honoree Make a gift to honor a birthday, anniversary, or to thank an outstanding hospital employee. First Name * Last Name * Notify Honoree Check here if you'd like us to let your honoree know you've made a gift in their honor. Honoree Email Address * Message to Honoree * About You I am an MLKCH: Employee Contract Staff Consultant Physician My MLKCH Department My Job Title Recognition Name My Employee ID I wish to remain anonymous. I wish to remain anonymous Your Mailing Information My Mailing Address * My Mailing Address 2 City * State * - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * Total Annual Donation: $ This amount is calculated automatically based on your selection above. Giving Acknowledgement * I acknowledge that my giving remains active until I request cancellation from the foundation by calling 323-457-3339. Total Annual Donation * $ This field is calculated automatically.