Athens Regional Health System
706.475.7000

Employee Generosity Program

Athens Regional Foundation GIFT ProgramYes, I would like to join GIFT, the Employee Generosity Program of Athens Regional Health System!

By completing this form, I pledge to contribute the amount shown below through payroll deduction at Athens Regional Health System and authorize this payment until I notify the Foundation office.

* Indicates required information
Please type your initials to serve as your electronic signature * 
First Name * 
Middle Initial 
Last Name * 
Email Address * 
Phone Number * 
Department * 
Amount you'd like to donate each pay period: * 




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