(Year) Tennessee Board of Regents Employee Giving Campaign (Insert Name of Institution) $ $ $ $ Number Amount Number Amount Number Amount Number of Amount Total Total Type of of A* for IA of CH* for CH of CS* for CS UW* for UW Number $ for All Deductions Donors Donors Donors Donors Donors Donors Donations Donations of Donors Agencies One-time only payroll deductions Regular deductions TOTAL *IA Independent Agencies CH Community Health Charities CS Community Shares UW United Way Agencies Number of Donors to Number of Employees Solicited: __________________ More than One Agency: _________________ Completed By: ________________________________ Date: ________________________ Phone No. ______________________ (Campus Coordinator) RETURN FORM by___(Date)_____TO: RESOURCES OFFICE TENNESSEE BOARD OF REGENTS 1415 MURFREESBORO ROAD, SUITE 350 NASHVILLE, TN
(Year) Tennessee Board of Regents Employee Giving Campaign (Insert Name of Institution) Type of Deductions Number of A* Donors $ Amount for IA Donors Number of CH* Donors $ Amount for CH Donors Number of CS* Donors $ Amount for CS Donors Number of UW* Donations $ Amount for UW Donations Total Number of Donors Total $ for All Agencies One-time only payroll deductions Regular deductions TOTAL *IA Independent Agencies CH Community Health Charities CS Community Shares UW United Way Agencies Number of Donors to Number of Employees Solicited: __________________ More than One Agency: _________________ Completed By: ________________________________ Date: ________________________ Phone No. ______________________ (Campus Coordinator) RETURN FORM by___(Date)_____TO: RESOURCES OFFICE TENNESSEE BOARD OF REGENTS 1415 MURFREESBORO ROAD, SUITE 350 NASHVILLE, TN
P-140%20Exhibit%202%20Report%20Form.docx