Please return completed form to:
The Office of University Engagement Alumni House University Advancement Phone: (732) 571-3489
Step 1: Will this be your first deduction, or replace or add to your existing payroll donations?
This payroll deduction is my first deduction.
This payroll deduction should replace all my other payroll donations.
This payroll deduction should be in addition to all my other payroll donations.
Step 2: Choose your area(s) of support by writing in a donation amount per paycheck.
Academic Support
Leon Hess Business School
School of Education
$_______ Scholarship Fund (307249)
$_______ Scholarship Fund (307247)
$_______ Excellence Fund (303081)
$_______ Excellence Fund (300020)
Wayne D. McMurray School of Humanities & Social Sciences
School of Science
$_______ Scholarship Fund (307248)
$_______ Scholarship Fund (307159)
$_______ Excellence Fund (303068)
$_______ Excellence Fund (300204)
Marjorie K. Unterberg School of Nursing and Health Studies
School of Social Work
$_______ Scholarship Fund (307126)
$_______ Scholarship Fund (307035)
$_______ Excellence Fund (303007)
$_______ Excellence Fund (303037)
Step 3: Finish and sign!
Total gift amount per paycheck (Add above lines together)
/ /
Payroll Deduction Start Date (Leave blank to begin as quickly as possible)
Payroll deductions will continue as stated above unless otherwise noted. You may stop your payroll deductions at any time by contacting the Office
of University Engagement at x3489.
I am interested in learning more about creating a named scholarship.
My spouse's company (___________________) may match this pledge.
Signature: _______________________________________________________________ Date:________________
2019 Employee Payroll Deduction
First Name:________________________ Last Name:______________________ Emp ID: __________
Staff (Hourly)
Please check all that apply:
Parent / Past Parent of Student
Current Student
General Support
$______ Monmouth University Library (03100)
$______ Center of Distinction for the Arts (303011)
Other Support
$_______ Athletics Director's Excellence Fund (303526)
$_______ Athletic team:______________( M / W )
$_______ Other Area: ____________________________________________________________________
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