Employees not wishing to use epledge may complete a paper pledge form.

Use ball point pen and write legibly.

  1. Fill in your full name.

  2. Fill in your Employee ID number if contributing through payroll deduction.

  3. Write in Department and Division/DDS Code (Your captain can supply you with this).

  4. Fill in a Work Phone Number.

  5. Fill in the Pledge Type:
    1. Cash/Check - Fill in the amount in the appropriate area if contributing through cash or check. Make your check payable to SECC.
    2. Payroll Deduction - Fill in the amount to be deducted each pay period and total the amount for the year if contributing through payroll deduction.

  6. Charitable Organization Designation - If you wish to designate your money to a particular charity, enter the five digit Charity code, the annual amount you wish to contribute to them, and the Charity name. Make your desired designations using the codes from the current brochure. If you do not wish to designate a charity, your donation will be split among the charities that receive donations during the campaign.

  7. Check off whether or not you want your name and address released to your charities of choice.

  8. Fill in the address if you want acknowledgement.

  9. If you are making a payroll deduction, you must date and sign the form. You also must enter the year 2017 on the two blank lines that are listed in the authorization in the lower right corner of the form.

When you complete the pledge form, you must turn it in to SECC Captain or Chair.

Please note: The SECC Captain/Chair will ensure the accuracy of the forms as they collect them from employees.