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Employee Giving Donation Form
Donation Form
*
1.
First & Last Name:
(Required.)
*
2.
Employee Number:
(Required.)
*
3.
Ridgeview Department & Cost Center:
Example: Foundation 7970
(Required.)
*
4.
Work Email Address:
(Required.)
*
5.
I would like to support the following campaign initiative.
(Required.)
ALL Campaign Initiatives (Annual Fund)
Arlington Campus
Cause for the Community campaign
Comfort Care Program
Employee Crisis Relief Fund
HALO Sleepsacks for Newborns
Joint Center Ice Pack Covers
Le Sueur Campus
Mental Health Services
Reach Out and Read Clinic Program
Ridgeview Nurse Residency Program
Roof-Top Gardens
Workforce Strategy
*New for 2026
Other (please specify)
6.
This gift is a tribute:
Honor
Memorial
7.
Name(s) for the tribute:
8.
Payroll Deduction
Payroll deductions are continuous unless otherwise directed.
$40/pay period
$20/pay period
$10/pay period
$5/pay period
$2/pay period
Other
9.
One-Time Payroll Deduction
Please enter payroll deduction amount:
10.
One-Time PTO Donation (# hours)
Employees will relinquish their chosen amount of PTO hours to Ridgeview. Ridgeview will then donate the full cash value directly to the Foundation. There are no taxes due from the employee nor will the employee be able to receive a tax deduction for the donation.
11.
Credit Card
Click on the link to make an online donation,
https://onecau.se/_bt88a1
12.
Cash or Check
Please send directly to the Foundation Office, 490 S. Maple St., Suite 110, Waconia
Cash
Check (please make payable to Ridgeview Foundation)
13.
I'm interested in learning of ways to include Ridgeview in my estate plan or will.
Please contact me.
14.
I am interested in volunteering with Ridgeview Foundation.
Please contact me.
None of the above
