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2 Imagine what you can do with your Fair Share gift to the UAB Benevolent Fund. Your pledge to the UAB Benevolent Fund supports educational programs, health screenings, outreach to the homeless and underserved, affordable homeownership, job training, cutting-edge medical treatment, and so much more. When you make a pledge, you make a significant impact on our world! JustImagine... NO MORE HUNGER A SAFE PLACE TO SLEEP EVERY CHILD REACHING HIS/HER POTENTIAL ACCESS TO PREVENTIVE HEALTH CARE ONGOING SUPPORT FOR PATIENTS AND CAREGIVERS RESEARCH FUNDING TO IMPROVE HEALTH CARE OUTCOMES "Fair Share giving allows each UAB employee the opportunity to show the 120+ local nonprofits that we appreciate their partnerships with UAB which strengthen the institution through opportunities for students in experiential learning, services to members of our UAB family, and millions in research funding each year." Selwyn M. Vickers, M.D., F.A.C.S. Senior Vice President and Dean of the School of Medicine

3 UAB s Habitat House UAB's Habitat House was sponsored entirely by UAB employee dollars designated through the Benevolent Fund. The 2015 Habitat home was built to handicap accessibility specifications to commemorate the 25th Anniversary of the Americans with Disabilities Act. My kids and I were blessed by UAB Volunteers and the Benevolent Fund with a beautiful home. The Benevolent Fund is a wonderful program that cares for people. On behalf of my family, thank you! Monique Dixon UAB s 2015 Habitat House Homeowner 992 UAB employees and students volunteered over 4,500 hours to build the 2014 and 2015 Habitat Houses $1,600, $1,400, $1,200, $1,000, $800, Years of Charitable Giving Over 8,000 meals provided to children and people in food insecure areas of Birmingham in 2015 $26.6 Million Employee Designations to Nonprofits $600, $400, $200, $ Employee Desingations Habitat House EEAP 2015 $1,716,454 Local Nonprofit Grants Community Impact Grant Administration & Fundraising $2.4 Million Local Nonprofit Grants

4 2015 Community Impact Grant $50,000 to Birmingham Public Library "Teens Engineer Birmingham" Selected by UAB employees STEM-based robotics programming at three library branches within walking distance of city schools Goal to increase college acceptance rates and successful entrance into today s workforce "UAB is excited about this partnership to help teens acquire and demonstrate science, technology, engineering, and mathematics skills. Our UAB student mentors will ensure that teens have the support and knowledge needed for success as future UAB students and career leaders." Abi Yildirim, PhD Director of Outreach, UAB School of Engineering Employee Emergency Assistance Program (EEAP) EEAP provides confidential financial assistance for UAB, Callahan Eye Hospital, Health Services Foundation, Health System, and VIVA Health employees to help with emergency situations including fire, flood, tornado, illness, or domestic violence. $3.6 Million through 4,207 awards to employees "Sometimes events happen in life that are unforeseen and can be quite devastating. I had an urgent medical need, and I am so appreciative for the assistance I received from the Employee Emergency Assistance Program. " Debbie Morgette Assistant Director, Student Advocacy EEAP Recipient

5 Bring a Ronald McDonald Family Room to UAB Located in UAB s Women and Infants Center (WIC) Educational and support programs offered by UAB staff, students, & volunteers. Laundry, showers, meals & sleeping rooms Pledge your support to bring a Ronald McDonald House Family Room to UAB! "A Ronald McDonald Family Room in WIC will support our families by providing opportunities like infant care education or therapeutic outlets and ensure a higher level of service from our great staff." Brandi Duke, RN, MSN, NE-BC Nurse Manager, Continuing Care Nursery Your Pledge Be a Fair Share Giver. We encourage employees to give their Fair Share (1 hour per month for hourly employees or 1% per month for salaried employees) to help us make a meaningful impact in Birmingham and throughout Alabama. Pledging is Personal. Your gift will be invested efficiently and effectively according to your choices. Your Pledge is Vital. Your gift is critical to UAB s collective efforts to positively transform our community. Thank you for your generosity! Designated Funds: Agencies you choose Maximum of three designations Any combination Use three digit agency code YOUR TAX DEDUCTIBLE GIFT Undesignated Funds: Employee Emergency Assistance Local Agency Grants Community Impact Grant Designations - Mix and match according to what inspires you to make a difference. Designation Examples Example 1 Leave blank and the entire gift is undesignated Example 2 1. Agency ### 2. Agency ### 3. Agency ### Example 3 1. Agency ### 2. Undesignated Donation will be evenly divided among your choices less operating costs.

6 UAB Benevolent Fund Pledge Form Employee Name: Blazer ID: (please print your full name) Campus Department: Campus Address: Campus Phone: Signature: Date: Please circle your payroll: UAB Health System HSF Callahan VIVA Please check here if you are changing your gift type/amount. Fair Share Giver through payroll deduction 1 HOUR PAY PER MONTH: Fair Share Giver (hourly employee) Check to donate one (1) hour of your pay per month. 1 PERCENT PAY PER MONTH: Fair Share Giver (salaried employee) Check to donate one (1) percent of your pay per month. Other Types of Giving FIXED AMOUNT PER MONTH: Good Faith Giver Check to donate a fixed amount of your choice. Specify amount: $ /month ONE TIME GIFT Check to donate a One Time Gift. Specify gift amount: $ Please circle your preferred method for this gift: Payroll deduction Attached cash Attached check # (include check number) ADDITIONAL ONE TIME GIFT TO UAB S HABITAT HOUSE (#581) Check to donate a One Time Gift. Specify gift amount: $ Please circle your preferred method for this gift: Payroll deduction Attached cash Attached check # (include check number) Leadership Giver Employees contributing $1,000 or more annually are recognized as UAB Leadership donors. Increasing levels of leadership recognition and matching funds are available to help you step into higher tiers of giving. For more information, contact us. Print name (may include spouse) as you would like it to appear for recognition purposes: Initial here if you do not want to be recognized in publicity as a Leadership Giver by the Benevolent Fund or United Way: Gift Designation - Give to nonprofits you are passionate about! Up to three designations can be made and may include both designated and undesignated funds. Undesignated funds support the Employee Emergency Assistance Program, Nonprofit Grants (supported nonprofits without designation codes) and then used where needed most; for Undesignated, use code #000. Please enter the name and/or three digit code assigned to each nonprofit Make checks payable to UAB Benevolent Fund. Please return this form to the Benevolent Fund office: Campus Address: AB B-84, zip Address: benevolentfund@uab.edu Fax Number:

7 Nonprofit Designation List ATeam Ministries 520 A.G. Gaston Boys & Girls Club 034 AIDS Alabama 245 Alabama Association of Nonprofits 162 Alabama Goodwill Industries 119 Alabama Head Injury Foundation 110 Alabama Kidney Foundation 181 Alethia House 101 ALS Association - Alabama Chapter 209 Alzheimer's of Central Alabama 085 Amelia Center 560 American Cancer Society 002 American Diabetes Association - Alabama Chapter 003 American Foundation for Suicide Prevention - AL Chapter 314 American Heart Association 274 American Red Cross - Mid-Alabama Region 004 ARC of Jefferson County 009 ARC of Shelby County 171 ARC of St Clair County 114 ARC of Walker County 010 Arthritis Foundation - Southeast Region 008 Autism Society of Alabama 287 Bell Center for Early Intervention 523 Better Basics 172 Big Brothers Big Sisters 012 Birmingham AIDS Outreach 524 Birmingham Jewish Federation 159 Birmingham Urban League 015 Blount County - Aid to Homeless Children 152 Blount County Central Alabama's Children's Fund 154 Blount County Children's Center 095 Boy Scouts of America - Black Warrior Council (Tuscaloosa Area) 016 Boy Scouts of America - Greater AL Council (Birmingham Area) 166 Boys & Girls Club of Central Alabama 014 Breast Cancer Research Foundation of Alabama 540 Cahaba Valley Health Care 350 Camp Fire Boys & Girls - Birmingham Area 020 Camp Seale Harris & Camp Sugar Falls (SDES) 355 Camp Smile-A-Mile 541 Catholic Family Services 022 Childcare Resources 071 Children's Aid Society 023 Children's Hospital of Alabama 025 Christ Health Center 547 Christian Love Pantry 115 Collat Jewish Family Services 080 Community Food Bank of Central Alabama 062 Concerned Citizens for Our Youth/ Beacon House 351 Crisis Center 027 Crohn's and Colitis Foundation - AL / NW FL Chapter 121 Cystic Fibrosis Foundation - AL Chapter 028 Developing Alabama Youth Foundation 167 Disability Rights and Resources 118 Easter Seals of the Birmingham Area 173 Epilepsy Foundation of Alabama 029 Family Connection 133 Family Resource Center of Northwest Alabama (Daybreak) 137 Fellowship House 033 Gateway 030 Girl Scouts of North Central Alabama 019 Girls Inc. of Central Alabama 035 Glenwood Autism and Behavioral Health Center 257 Habitat House - UAB Sponsored 581 Habitat for Humanity - Greater Birmingham 138 Hand-in-Paw 542 Hands on Birmingham 286 Hispanic Interest Coalition of Alabama ( HICA!) 258 Impact Family Counseling 175 Jefferson County Central Alabama's Children's Fund 153 Juvenile Diabetes Research Foundation - Alabama Chapter 038 Kid One Transport 032 Lakeside Hospice 176 Legacy YMCA - Bessemer 068 Legal Aid Society 156 Leukemia & Lymphoma Society 040 Levite Jewish Community Center 037 Literacy Council 134 Lupus Foundation of America 104 March of Dimes - Alabama Chapter 041 M-Power Ministries 544 Multiple Sclerosis Society - Alabama Chapter 050 Muscular Dystrophy Association of Alabama 045 National Alliance on Mental Illness (NAMI) 105 Oasis, A Woman's Counseling Center 259 Parkinson Association of Alabama 580 Pathways 077 Planned Parenthood* 151 Ronald McDonald House Charities 251 Safehouse of Shelby County 277 Salvation Army - Greater Birmingham Area 177 Salvation Army - Walker County 058 Sav-A-Life* 250 Shelby County CASA 174 Shelby County Central Alabama's Children's Fund 157 Shelby County Children's Advocacy Center/Owens House 354 Shelby Emergency Assistance 063 Sickle Cell Disease Association of America, Central AL Chapter 421 Sight Savers 545 Spina Bifida Association of Alabama 240 St Anne's Home 546 St Clair Children's Advocacy Center 129 St Clair County Central Alabama's Children's Fund 260 St Clair County Day Program 206 St Clair County DHR 352 Susan G. Komen for the Cure - North Central Alabama 312 Travelers Aid Society 060 Tuberous Sclerosis Alliance 500 United Cerebral Palsy of Greater Birmingham 178 United Community Centers, Inc. 061 United Way of Central Alabama(Birmingham Area) 999 United Way of Madison County 600 Walker County Central Alabama's Children's Fund 278 Workshops, Inc. 067 YMCA of Birmingham 069 YWCA of Central Alabama 070 *These affiliate agencies receive designations only, they do not receive any undesignated funds Additional nonprofits receive funding through our local grant process, which is funded through undesignated pledges. Visit uab.edu/benfund for more information & application guidelines.

8 AB B nd Avenue South Birmingham, AL Address: Phone Number: Fax Number: Find us online! "On April 28, 2014, I was in a tornado and lost everything. The Benevolent Fund helped me replenish my family's needs. They were a true blessing to us." Erica Taylor The Kirklin Clinic Employee & EEAP recipient