Employee / Workplace Giving Form - MACCThank you for your interest in supporting Mother and Child Charity (MACC) through your workplace. This form allows employees and workplace champions to indicate how they or their employer would like to support MACC. Our team will follow up to coordinate next steps.Please enable JavaScript in your browser to complete this form.Your Information Name *FirstMiddleLastEmail *EmailConfirm EmailPhoneAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmployer Information Company Name *Employer Name *FirstLastJob Title *Email *EmailConfirm EmailPhoneWebsite / URLAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow would you like to support MACC through your workplace?Employee giving / Financial support *Payroll deduction giving programEmployer matching gift programOne-time employee donation Recurring employee donation Workplace engagement / FundraisingPeer-to-peer fundraising (employee-led)Workplace fundraising campaign or challenge Cause related event or team fundraiser Volunteer / Skills based supportTeam volunteering opportunitySkills based or professional volunteer supportPayroll deduction / Matching giftsPlease share what you know about your company's payroll deduction or matching gift program (platform used, frequently, or HR contact if known).Workplace product / In-Kind supportEmployee product donation programGift cars or prepaid cardsAirline miles or travel rewardsHotel or lodging pointsTranspiration passes / creditsEvent / experience ticketsNew bulk product donationsPeer-to-Peer or Workplace Fundraising Please describe the type of fundraising campaign or challenge you are interested in hosting. Would you like MACC to set up the donation page?YesNoNot sure yetVolunteer or Skills based SupportPlease describe the type of volunteer or skills based support you or your team can provide.Employee Product / In-Kind DonationsPlease describe the items or support being offered, including type, quantity, and whether items are new and unused.Travel Rewards / Gift Cards / TicketsPlease provide details about the rewards, gift cards, or tickets you are offering (program, approximate value, quantity).When would you like to move forward?Immediately Within 30 days1-3 monthsExploring optionsNot sure yetHow did you hear about MACC?Employer or colleagueReferralEvent Website Social mediaOnline searchOtherComment or MessageImportant Note: All workplace and employees contributions are subject to MACC review and for gift cards, travel rewards, tickets, or similar non-cash items, please do not transfer or activate items until MACC confirms acceptance and provides instructions. Consent and Acknowledgment *I confirm that the information provided is accurate and I consent to MACC contacting me regarding this submission. I understand that participation and contributions are subject to MACC review and acceptance and acknowledge MACC's privacy policy. Submit
