Annual Fund Payroll Donation Form

Fields marked * require an entry.

Employee Annual Fund Payroll Donation Form

Please complete the form below. Allow one pay-cycle for the change to be reflected on your paycheck. Thank you in advance for your gift!

Select amount to be donated each pay period:*

Other gift amount:

I understand that the amount selected above will be deducted from my paycheck starting the next payroll cycle until I request a change or cancelation:*

Yes

Comments:

Contact Information

Company:

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*



What is the Annual Fund? Is my gift to the Annual Fund tax-deductible? Are employees expected to support the Annual Fund? How can I give to the Annual Fund? How do I sign up for automatic payroll donations? How do I end my automatic payroll donations? How do I change the amount of my payroll donation? What documentation do I need to file my taxes? Who can I contact if I need further information?