AGives! Payroll Deduction | Associated Grocers, Inc.

Name(Required)

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Department(Required)

Your donation will benefit AGives!, Associated Grocers non-profit organization, as well as United Way. Please allocate your dollars below.

Allocation(Required)

Percentage to AGives!

Percentage to United Way

Specific Amount for AGives!

Specific Amount for United Way

I understand my weekly pledge will continue until I elect to cancel the contribution.

Payroll Deduction

Specific Amount Each Week

Deduction Options(Required)

One Time Payroll Deduction

Cash or Check Donation

Deduction Amount(Required)

I will drop off my cash or check contribution with HR. Check should be made payable to the AGives!

Authorization(Required)

I hereby authorize Associated Grocers to deduct my pay for this cause as referenced above.

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