Get Gem Membership Form - Beacon Health System

Filling out the GEM Membership Form is a straightforward process that allows you to contribute to Beacon Health System. This guide provides you with step-by-step instructions to complete the form online effectively.

Follow the steps to complete the GEM Membership Form online.

1. Click ‘Get Form’ button to access the GEM Membership Form and open it in a suitable editor.
2. Begin by entering your full name in the 'Employee Name' field as it appears in your official documents.
3. Fill in your 'Employee Number' in the corresponding field to help identify your contributions.
4. Provide your 'Department Name' in the allocated space to categorize your membership.
5. Indicate your contact number by entering it in the 'Phone Number' field.
6. Complete your 'Home Address' fields including 'City', 'State', and 'Zip' code for verification.
7. In the contribution section, indicate the amount you wish to donate on a payroll deduction basis under 'Payroll Deduction Contribution.'
8. Select your preferred jacket size for the membership package from the options provided for both women's and men's sizes.
9. Decide how you would like to designate your contributions by choosing one of the listed options under the designation section.
10. Review the confirmation statement and provide your signature in the designated area along with the date to authorize the deduction.
11. Once all fields are completed and checked for accuracy, you can save your changes, download the form, print it for submission, or share it as required.

Take action now and complete the GEM Membership Form online to support Beacon Health System.