
Pleasereturnformto:ISUFoundation,921S8
th
AveStop8050,Pocatello,ID832098050
FormoreinformationcontactKalleeValentineat2822994orvalekall@isu.edu
Payroll: FS2015SOL3
EmployeeName
Spouse
Department
BengalID
Preferredaddress
City
State
Zip
Phone
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GiftDesignation
I/WewouldliketosupportIdahoStateUniversitythrough:
□ISUAnnualFund(scholarships)
□Dean’sExcellenceFund(specifycollege)
□StaffCouncilScholarship
□EliM.ObolerLibrary
□BengalAthlecs
□Benny’sPantry
□KISU
□Other(specifyfund)
GiftDetails
I/Wewouldliketomakeagiftintheamountof$_______________________
□NewPayrollDeduction□UpdatedCurrentPayrollDeduction( willcancelpreviousdeduction)
IherebyauthorizeandrequesttheIdahoStateUniversityPayrollOfficetodeducttheamount(s)
designatedbelowfrommypaycheckeachpayperiod,andtoremitthewithheldamount(s)tothe
IdahoStateUniversityFoundation.
1. Pleasededuct$__________
fromeachpaycheckfor_______numberofpayperiods.
TosupportmorethanonefundpleasesubmitmultipleformsorcontacttheFoundation.Ifthe
numberofpayperiodsisnotdefined,thisdeductionwillcontinueuntilemployeenotifiestheISU
PayrollOfficeinwriting.
Employeesignature Date
□EnclosedCheck
(payabletoIdahoStateUniversityFoundation)
□CreditCard(orgiveonlineatwww.isu.edu/gift)
□MasterCard□Visa□AmericanExpress□Discover
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Employeesignature Date
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