Hudson Hospital Foundation | 405 Stageline Road | Hudson, WI 54016


Hudson Hospital Foundation Payroll Deduction Donation Form
Thank you for your donation to the ONE Campaign. Please submit your payroll deduction donation by April 30th. The deductions will start the first pay period in September. To make a one-time credit card donation, please utilize Hudson's online donation page.

Required fields are marked with *
Thank you for your contribution to the ONE Campaign. Your pledge will make a world of difference to those we serve. A letter will be sent to acknowledge your donation. For a receipt for tax purposes, please refer to your year-end pay summary on Employee Self Service.

By entering my initials below, I authorized these donations to be taken out of my paycheck starting September. I understand if I check sustaining donor that I will have the option to change or stop my contributions each year during the ONE campaign.

* Payment method - If you wish to make donations by credit card, please click here
Hudson Hospital support
Organization-wide support
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Apply my dollar ($) donations to (please select at lease one designation for your gift):
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Initials
If you have any comments or notes regarding your gift, please write them here:
*Would you like to be a sustaining donor? (As a Sustaining donor, your charitable contribution, via 24 payroll deductions, will continue until you request a change. You will receive an annual opportunity to increase, decrease, discontinue or reallocate your gift. It's that simple! Thank you!)
*Would you like to be a sustaining donor? (As a Sustaining donor, your charitable contribution, via 24 payroll deductions, will continue until you request a change. You will receive an annual opportunity to increase, decrease, discontinue or reallocate your gift. It's that simple! Thank you!)