Brighter Future Fund – Employee Giving – Credit Card / PayPal / Venmo Switch to Payroll Deduction "*" indicates required fields Step 1 of 3 33% NAME (as listed with HR):* First Name Last Name Email* CENTERSTONE STAFF ID (available in Workday):* I WOULD LIKE TO GIVE (click and choose one):** $25 $50 $100 $250 $500 Other Other - Amount Total WHERE I WOULD LIKE MY DONATION TO BE USED (click and choose one):*Brighter Future Fund - for employee relief Billing Address* Street City State StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Code Mailing Address Same as Billing Address Street City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Tax Receipt Options Electronic only - emails as entered above. Electronic with paper copy mailed Payment Method* Help by Covering Transaction Fees? Yes, I'll help. Payment Processing Fees Price: $0.00 Payment Processing Fees Price: $0.00 Total Payment MethodPayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Card Type American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Card Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 CVV Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.
