Intel Retiree - Benefits - Intel Involved Matching Grants Program Form


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Intel Involved Matching Grants Program Form

Intel Involved Matching Grants Program

The Intel Foundation matches the time that Intel employees and U.S. retirees spend volunteering in schools and non-profits with a cash donation through the Intel Involved Matching Grant Program (IIMGP). For more information on the Intel Involved Matching Grants Program, please go to: www.intel.com/about/corporateresponsibility/community/matchgrants.htm.

Deadline to submit 2011 volunteer hours: January 15, 2012. Any 2011 hours submitted after that date will not be eligible for the Intel Involved Matching Grant Program. Grant payments will be sent to recipients in Q2 2012.

Intel Involved, Intel's volunteer program managed by Corporate Affairs, encourages employees to take an active role in their communities. Intel Involved is available to blue badge and retiree employees only, and participation is entirely optional.

Intel Involved data is managed on behalf of Corporate Affairs Group by an external third party vendor. If you choose to participate in the program, your WWID, name, e-mail address, and department information will be transferred to the vendor and will be refreshed each time new hours are reported. The vendor will not transfer or sell our personal information or use it for any other purposes. Volunteer records associated with school and non-profit grants will be kept in the database for seven years to fulfill tax requirements. By completing the information below and clicking "Submit" you are agreeing to this statement.

* = Required field

Intel Retiree Employee Information
(Spouses are not eligible for this program)

Legal Name *
WWID *
Address *
City *
State/Country *		Zip *
Email address: * (if applicable)

Non-Profit Organization / School Information

Organization / School Name *

Principal / Contact

Address *

City *

State/Country *
Zip *

EIN # (Number assigned by Federal
government. US non-profits only):

Volunteer activities

Start Date
MM/DD/YY End Date
MM/DD/YY Event / Type of volunteer activity Number of
Hours

*

*

*

*

I certify that at the time of the volunteer activity, I qualified as an eligible retiree of Intel Corporation. I further certify that these volunteer hours are my personal contribution and that neither I nor any member of my family received or will accept a benefit in return for or as a results of these volunteer hours.

I certify that the volunteer hours were used in accordance with the program's guidelines.