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Donating by deduction at source

Donating by deduction at source is the easiest way for a CIUSSS employee to make regular contributions to the Foundation. For just a few dollars per pay cheque, you can make an additional difference in the lives of the young people you support every day.

Thank you for your daily involvement! We appreciate you!

Deduction at source form

Name*
Personal address*

Salary deduction

I authorize the CIUSSS du Centre-Sud-de-l' Île-de-Montréal Payroll Department to deduct from each of my paychecks the amount of:*

Signature

Enter your name
MM slash DD slash YYYY
Acceptance*

  • Download, print out, and complete the form
  • Send via internal mail to the Foundation: code 34

To stop or change a payroll deduction, contact your payroll department.