FOR GOVERNMENT AND CORPORATE EMPLOYEES ONLY
For VI Government Employees Only
Name of your Department
Your Street or Mailing Address
Please choose which contribution you would like to make.
Please recognize me as a member and my level of contribution in your TakeTwelve Special Membership Edition.
Payroll Deduction for Foundation Members:
I would like my contribution to be deducted every pay period by my payroll division and mailed to you on my behalf.
Yes, I acknowledge that I would like my contribution deducted every pay period.
Interested in Volunteering
Please indicate which activities interest you.
Check all that apply:
Fun Activities for kids
WTJX Educational Initiatives
Community Health Outreach Activities
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