Online Contribution Form

NOTE: This is not payroll deduction. To make a donation via payroll deduction, call the MI HR Service Center at 877-766-6447.

Your Information
Name*
First Last
Phone Number*
Address
Street Address Address Line 2 City State ZIP Code
Email Address
Department
Employee ID
Staff Activity/Type
- I am a retired State of Michigan Employee.
Contribution Designation
Please indicate the Umbrella Organization(s) and Member Agency Code(s) to which you would like to donate.
Charity 1*
Donation Amount*
Charity 2
Donation Amount
Charity 3
Donation Amount
Would you like to give to additional charities?
- Yes
- No
Charity 4
Donation Amount
Charity 5
Donation Amount
Charity 6
Donation Amount
Donation Total
$0.00
Acknowledgement of Contribution
- I wish to have my charitable gift acknowledged by the organization(s) I have designated.
Name
This field is for validation purposes and should be left unchanged.