Yes! I want to donate to CHLA through the Team Member Giving Program

As a member of the CHLA family, you know first-hand that the costs of providing the finest medical care to children are immense and that the needs are urgent. 

Thanks to your daily work, dedication and your charitable support, we can continue to provide the very best care today, while helping develop new treatments and cures for children tomorrow. Thank you

You may also print the form and send it to chlagives@chla.usc.edu or to MS #29.

Your Information
I would like to remain anonymous
Gift Designation

If this gift is in honor of someone

Donation Options

Payroll Recurring Donation

Deduction Amount:

Vacation Hours Deduction

If you would like to make a donation of vacation hours, please complete the form by clicking here and forwarding it to payroll@chla.usc.edu. 
Please allow two weeks for processing. The deadline to submit vacation hours to count toward the calendar year is the second Friday in December.

Additional Information

VOLUNTARY AUTHORIZATION FOR PAYROLL DEDUCTIONS

By typing my name and clicking Submit below, I verify that I have reviewed my Team Member Giving Program Donation Options elections above and I hereby voluntarily authorize Children’s Hospital Los Angeles to make payroll deduction(s) from my pay, in the amount(s) specified, for the donation(s) that I have voluntarily elected and based on the frequency that I have voluntarily elected. I understand that these deduction(s) will be made on a post-tax basis to the extent available, unless otherwise disclosed. I may revoke this Authorization by contacting Payroll, in writing, of my wish to do so.

I acknowledge that I have read this Authorization, understand it, and voluntarily agree and consent to its provisions.

I understand that by clicking the Submit button below, this shall have the same force and effect as my written signature.