Methodist Richardson Medical Center Employees
The Methodist Richardson Medical Center Foundation 30
Minute Club is a group of Methodist Health System
employees who voluntarily join together to freely contribute
a portion of their salary for projects supporting the welfare,
purpose, and goals of Methodist Health System, its
employees, and patients.

MEMBERSHIP: Employees donate a minimum of 30 minutes of their
base salary per pay period

BENEFITS: The joy, pleasure, and pride of giving; community
investment; special events and programs; tax deduction
Employee Name (Please Print) _____________________________________________________________
Employee Home Address _________________________________________________________________
City _____________________________________________________ State _______ Zip ______________
Date of Enrollment ____/____/____
Department ___________________________________________
I am a Methodist Richardson Medical Center employee and work at (check one):
Bush Renner Campus _________________ Campbell Road Campus ____________________
Employee Signature _________________________________ Employee # __________________________
I hereby authorize Methodist Health System to deduct 30 minutes of my base salary from my payroll check per pay
period. I understand that this contribution is continuous until written amendment or cancellation by me.
I understand that this contribution is continuous until written amendment or cancellation by me.
PLEASE SELECT ONE
Thirty-Minute Club Projects:
These projects benefit the welfare, purpose, and goals of Methodist Richardson Medical Center, its
employees, and patients. Projects are suggested by Methodist Richardson staff and administration and by
members of the Thirty-Minute Club.
Basic Employee Needs Fund (BEN FUND):
This fund was created to give employees a way to financially support their fellow employees during crisis. Final
distribution of funds is determined by a set criteria and the 30 Minute Club Executive Committee.
Methodist Richardson Medical Center Foundation General Fund:
Underwrites projects, programs, and expenses that are not part of a specific fundraising effort to ensure the
mission of Methodist.
Return Form
1. During orientation
2. Methodist Richardson Medical Center Human Resources Department (Bush Renner Campus)
3. Methodist Richardson Medical Center Foundation Department (Campbell Road Campus)
For questions, please call the MRMC Foundation at 469-204-6990 or email [email protected]
Methodist Richardson Medical Center Empleados
El 30 Minute Club de Methodist Health System Foundation es un grupo de
empleados de Methodist Health System que se reúnen en forma voluntaria
para aportar libremente una parte de su salario para proyectos que
promueven el bienestar, el objetivo y las metas de Methodist Health
System, sus empleados y pacientes.

MEMBRECÍA: Los empleados donan un mínimo de 30 minutos de
su salario básico por período de pago.

BENEFICIOS: La alegría, el placer y el orgullo de dar; inversión en la
comunidad; programas y eventos especiales; deducciones
impositivas.
NOMBRE DEL EMPLEADO (EN LETRA DE IMPRENTA) _____________________________________________
DOMICILIO PARTICULAR DEL EMPLEADO ______________________________________________________
CIUDAD ______________________________ ESTADO__________________ CÓDIGO POSTAL ____________
FECHA DE INSCRIPCIÓN _____/______/______ DEPARTMENTO ___________________
SELECTLA Uno : Bush Renner LOCALIZACION _____ Campbell CALLE LOCALIZACION ________
FIRMA DEL EMPLEADO _________________________
Por el presente formulario, autorizo a Methodist Health System a deducir 30 minutos de mi salario básico de mi cheque de
nómina por período. Comprendo que esta contribución es continua hasta que yo la enmiende o cancele por escrito.
SELECCIONE UNO
Proyectos Del MRMC Campus
Financia proyectos, programas y gastos que no forman parte de un esfuerzo específico de recaudación
de fondos, a fin de asegurar el cumplimiento de la misión de Methodist.
FONDO BASIC EMPLOYEE NEEDS (BEN FUND) Financieramente ayudar Methodist Richardson Medical Center
empleados durante nf inv. Final difusion hecho BEN Comite despues revisar necesario aplicacion.
FONDO GENERAL DE METHODIST Richardson Medical Center Financia proyectos, programas y gastos que no
forman parte de un esfuerzo específico de recaudación de fondos, a fin de asegurar el cumplimiento
de la misión de Methodist.
Regreso Hoja
1. Durante la orientación
2. Si usted no puede entregar este formulario al final de la orientación, entréguelo en la oficina de Methodist
Richardson Medical Center Human Resources Department (Bush Renner Campus)
3. Si usted no puede entregar este formulario al final de la orientación, entréguelo en la oficina de Methodist
Richardson Foundation. (Campbell Road Campus)
Pregunta MRMC Foundation at 469-204-6990 or email [email protected]