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Effective Give Workplace Giving
Ready to start making an impact for charity through your workplace? Complete the form to get started!
Questions? Email us at workplace@effectivegive.org
Effective Give Workplace Giving Enrollment
Personal Information
Please complete the information below.
Prefix
*
Dr.
Miss
Mr.
Mrs.
Ms.
First Name
*
Last Name
*
Birth Date
*
/
/
(mm/dd/yyyy)
Email
*
Phone Type
Business
Home
Mobile
Phone
*
Address 1
*
Address 2
City
*
State
*
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
AMERICAN SAMOA
FEDERATED STATES OF MICRONESIA
GUAM
MARSHALL ISLANDS
NORTHERN MARIANA ISLANDS
PALAU
PUERTO RICO
U.S. MINOR OUTLYING ISLANDS
VIRGIN ISLANDS
ARMED FORCES AMERICAS
ARMED FORCES
ARMED FORCES PACIFIC
ALBERTA
BRITISH COLUMBIA
MANITOBA
NEW BRUNSWICK
NEWFOUNDLAND AND LABRADOR
NOVA SCOTIA
NORTHWEST TERR.
NUNAVUT
ONTARIO
PRINCE EDWARD ISLAND
QUEBEC
SASKATCHEWAN
YUKON
Zip
*
Company Name
*
Login Name
*
Login Password
*
Retype Password
*
Contribution Amount
Which option best describes your compensation structure?
*
Hourly
Salary
1099/Contract Labor
Other
***Only complete this section if you are a Salary or 1099 Employee***
In the field below please enter the specific dollar amount that you wish to contribute from each regular pay period. Once the program starts, your compensation will be reduced by this amount for each pay period going forward until you elect to make a change. The amount below should not include any matching contributions that your employer may offer.
Contribution Amount
***Only complete this section if you are an Hourly Employee***
In the field below please enter the specific dollar amount that you wish to contribute per each hour worked. Once the program starts, your hourly rate will be reduced by this amount going forward until you elect to make a change. The amount that you enter below should not include any matching contributions that your employer may offer.
Hourly Contribution Amount
Beneficiary Advisement
Where would you like us to designate contributions? You will have the opportunity to update this at a later date if needed.
Charity
Donor Advised Fund
Place of Worship
I am not sure, please have an Effective Give representative contact me for help.
If you selected "Charity" or "Place of Worship" please complete the following fields to the best of your ability. Our team will attempt to complete any fields left blank and may reach out to you for additional clarity.
Charitable Organization Name
Charitable Organization Website
Charitable Organization EIN
Terms and Conditions
By participating in Effective Give's Workplace Giving Program you acknowledge this program is not intended to be an employment agreement. Your participation does not constitute wages or other compensation for services rendered or to be rendered. Your participation is voluntary and you are free to elect not to participate or to opt out at any time upon notice. This program is not intended to constitute a binding obligation enforceable between participating employer and participating employee. You acknowledge that your participation is not a satisfaction of any personal charitable pledge or personal obligation to any charitable organization. The charitable organizations receiving funds from this program are not restricted in their use of these donations. Your involvement will not result in wages or other compensation for services rendered or to be rendered; rather, compensation you might have earned after enrolling will remain funds of your employer. You employer has separately enrolled in the Program, pledging to make a contribution to Effective Give to support public charities. Your enrollment is not intended to create an obligation that you can enforce against your employer. Contributions to this program will not result in a personal charitable deduction as the tax benefits will be realized through a reduction of your adjusted gross income. You commit that the information on this form is true, complete and accurate and that you are completing this form for yourself.
Enrollment Acknowledgement
*
I hereby enroll and agree to participate in the Effective Give Charitable Giving Program (Program). I understand that my participation is voluntary, and I have the right to opt out at any point.
No, I do not want to participate in this program.
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Contact Us
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