Employee Giving Enrollment Form printable pdf download

Employee Giving Enrollment Form

Employee Giving Enrollment

The Safeway Foundation is a 501 (c) (3) public charity to benefit the communities where

the company operates stores. Funds are donated to local organizations that are aligned

with the four priority areas of giving:

Hunger Relief, Education, Health & Human

Services, and Supporting People with Disabilities. 100% of all employee contributions

are donated directly to non-profit organizations.

By donating to the Safeway Foundation, you’ll be joining thousands of your co-workers

in making a difference in the communities where you live and work. Your contribution is

fully tax-deductible. Simply complete the information below to begin weekly payroll

deductions. Thank you in advance for your generosity.

Amount: ____$1.00 ____$2.00 _____$3.00 _____ $4.00 _____ $5.00 _____ Other

Name

Employee #

Street Address

City

State

Zip

Corporate or Store #

Phone #

Signature

I give permission to have the selected amount deducted from my pay weekly as a donation to

The Safeway Foundation.

Please return this form to your division Public Affairs department or to

Corporate Public Affairs, Pleasanton, Bldg. G

Employee Giving Enrollment Form