Employee Giving

2016 Employee Campaign Logo 


Personal Information
New this year! Continuous Giving

Continue my gift/pledge shown below every year until I change or cancel it. I understand I will be recognized and receive my thank you gifts annually, but will not receive a pledge card.

Ways to Give


Set this value to the amount you would like deducted per payroll period (26 times per year).

Enter the amount for your one-time donation

Payment Information

(What's this?)


Security number example

I wish my gift to be anonymous.

To make your gift in honor of, or in memory of someone, please fill out the following information:

Gift Designation (Please credit my gift as follows)*

100% for

50% for the Shoreline Cancer Center and 50% for

Sign Up for our Monthly e-Newsletter

Confirm Your Information

28 Crescent Street
Middletown, CT 06457

Copyright © 2018   All Rights Reserved.