2020-21 EMPLOYEE GIVING CAMPAIGN FORM
Please submit this form to the Foundation by emailing to foundation@ladelta.edu or dropping it off at
the office located on the 3
rd
floor at the Monroe campus in Room 338. All donations are tax-
deductible. If you have any questions, please contact Missy Amy at x4365. Your gift and support of
LDCC is greatly appreciated.
NAME: _______________________________________________________________________
PHONE: ________________________ EMAIL: _______________________________________
DEPARTMENT: __________________________________________
EMPLOYEE TYPE: ⃝ FT STAFF ⃝ PT STAFF ⃝ FT FACULTY ⃝ PT FACULTY
SIGN-UP FOR A PAYROLL DEDUCTION:
$ ________________per paycheck
Payroll deduction gift to begin on (date):________________________________
MAKE A ONE-TIME PAYMENT:
I wish to make a one-time contribution in the amount of $ __________________
Check/cash enclosed (payable to LDCC Foundation)
Payment to be made via the Foundation’s secure website:
https://www.ladelta.edu/foundation/make-a-gift
(Please write “Employee Giving” in the
donation notes field.)
DESIGNATE YOUR GIFT:
Scholarships Emergency Fund –Awards students’ gap funding for tuition, fees or books
and college program support grants for faculty and staff in an area of greatest need.
Emergency Relief Fund- Awards students, faculty or staff funding in emergency
situations. (ex. Covid-19 Emergency)
Chancellor’s Fund- Donation made for the Chancellor to fund in areas of need at the
college.
________________________________________________ ___________________________
EMPLOYEE SIGNATURE DATE
