Giving Through Payroll Deduction Please print clearly
Employee Name: ID Number:
I authorize Concordia University to deduct the following charitable gift to Concordia University, St. Paul
from my paycheck as follows:
A) Amount:
as a one-time gift from the next payroll.
~ or ~
B) Amount:
per pay period, which will start on the next payroll date and continuing
indefinitely (until I provide ten days written notification to the Advancement Office to
discontinue).
Purpose of Donation:
The Opportunity Fund (CSP’s area of greatest need)
Other (multiple designations welcome):
Employee Signature:
Today’s Date:
Thank you for your support and commitment to Concordia University, St. Paul!
For assistance with this form, please contact the Advancement Office at x 8222
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