Fields marked * require an entry.

Thank you in advance for your gift!

Please allow one pay-cycle for any changes to be reflected in your paycheck. Automatic payroll donations will continue until the Annual Fund receives your request to stop donations.

If you have questions about your payroll donation or would like to discuss different options, please contact giving@calhoun.org.

Annual Fund Payroll Deduction Form

Division/Department:*

Select Total Amount to be Deducted Per Pay Period:*

$5.00

$10.00

$25.00

$50.00

Other

If "Other" is selected, please enter the amount here.:

Electronic Signature

Payroll donations will continue until the Annual Fund/Development Team receives a request to stop. Please type your name to confirm:*

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:*