Workplace Giving Form

YES! I would like to donate to the Give Where You Live Foundation's Workplace Giving Program.

Workplace Giving is a small regular tax-deductible donation from your pay. It's coordinated by your employer's payroll who will deduct your chosen donation amount from each pay and forward it the Give Where You Live Foundation.

To sign up to Workplace Giving simply complete your details below and the amount you would like to donate and how that equates to your pay cycle.

Please note that once this form is completed and submitted it will be sent to the Give Where You Live Foundation, and your organisation's payroll to implement and commence donation deductions from your pay.

Your donations will automatically appear on your end of financial year Income Statement / Payment Summary.

Since 1954, the Give Where You Live Foundation Workplace Giving donations have been working to help create a fairer Geelong / G21 where all people and places thrive.

Give Where You Live has deductible gift recipient (DGR) status, and your contribution across the year will be included in your end of year income statement (payment summary) as a tax deduction – no receipts required. Additionally, the Workplace Giving Program does not affect the way your gross income, super guarantee payments or fringe benefits are worked out.

Name*

First Name

Last Name

Organisation*

If your organisation is not listed, please select Other

My Loaned Executive is*

Department

Employee No. (If Applicable)

Email*

Phone*

My Loaned Executive is:

Please click one of the options below to nominate your donation amount

I am new to workplace giving I am already making donations via workplace giving

I will commence my Workplace Giving Donations with a weekly amount of:*

$5 $10 $15 $20

Other:

I will increase my current Workplace Giving Donations by the additional amount below per week:*

$5 $10 $15 $20

Other:

Because I get paid:*

Every week Every fortnight Every month

This means I have committed to deduct the amount below per pay: * A$

This means I have committed to deduct the additional amount below per pay: * A$

I agree to you speaking to my payroll to arrange for this to be deducted from my pay Yes, I would like to receive communications from Give Where You Live Foundation

Opt in to WIN a $1000 e&s gift voucher

YES No

e&s have kindly donated $1000 gift voucher to support and encourage our Workplace Giving Program.

Signature*

[clear]

Use your mouse or finger to draw your signature above

Thank you for helping to Build a Better Community!
Please be assured your privacy is important to us and your details remain confidential, we will not supply your details to any other organisation or individual. Link to our privacy policy is here: GWYL-Privacy-Policy.pdf (givewhereyoulive.com.au)