Instructions for Completing the Faculty-Staff Contribution Form
1. If you complete your form electronically, please do not fill out the form directly on the
Aerie site. Download the Contribution Form from Aerie, save the form to your
computer, complete, save and email the completed form to the Foundation.
2. Complete the form by designating the type of donation youd like to make: Monthly or
One-Time Payroll Deduction or one payment by cash/check. Please make check payable
to: Chattahoochee Tech Foundation.
3. Confirm your monthly payroll deduction amount or simply fill in another designated
amount.
4. Choose how your donation will be used: Greatest area of need or if youd like your
donation to go to a specific need.
5. Sign the form, by typing your name or signing a printed copy, include your Employee
Payroll ID number. Your employee ID number is the number associated with your
employee self-service account when submitting leave time, checking your
compensation, etc.
6. Return your form by email to: Foundation@ChattahoocheeTech.edu or you may send
via interoffice to: Chattahoochee Tech Foundation, 980 S. Cobb Drive, Marietta, GA
30060, Mail Stop: MA-202.
If you need assistance with completing your form, please feel free to contact us at
Foundation@ChattahooocheeTech.edu or 770-528-4461.
Monthly Payroll Deductions are continuous and do not require renewal each year.
Should you desire to end your monthly deduction,
please notify the Foundation in writing.
2/10/19
Faculty-Staff Campaign Contribution Form
YES!, _________________________________________ would like to support the Faculty-Staff Campaign
with a gift to the Chattahoochee Tech Foundation.
My gift will be a monthly payroll deduction that I have selected below. My gift will continue to be
deducted monthly until I cancel my gift, in writing, to the Foundation or terminate employment with
Chattahoochee Technical College.
My gift will be a one-time payroll deduction of $____________ from the next payroll cycle.
My gift will be a one-time gift by cash or check in the amount of $____________. Make checks payable
to: Chattahoochee Tech Foundation
Monthly Payroll Deduction Gift Amount
$100 (=$1,200/year) $60 (=$720/year) $40 (=$480/year) $20 (=$240/year)
$10 (=$120/year) $5 (=$60/year) $3 (=$36/year) $1 (=$12/year)
Other $ ___________________
Gift of $5 per month/$60 per year receive a T-Shirt. Tell us your T-Shirt size (XS - 5XL):__________
How will your gift make a difference? You decide:
Greatest Area of Need - Unrestricted gifts are used to support the Foundation’s greatest area of need, which may
change from campaign to campaign. These gifts allow the Foundation to provide Emergency Grants for students,
Faculty/Staff Conference Grants, support college-wide needs, and Foundation operations.
Restricted - Please designate my gift to:
Scholarships (if for a specific scholarship, please include name) ________________________________________
Other Foundation Fund ________________________________________________________________________
EMPLOYEE SIGNATURE & CONFIRMATION
By signing/typing my name below and submitting this form to the Chattahoochee Tech Foundation, I affirm that I
understand the terms of my gift agreement.
Required:
Signature Line: ______________________________________ Employee Payroll ID: ____________________________
Today’s Date: _______________________________________
Mail or Email Completed Form:
Chattahoochee Tech Foundation, 980 S. Cobb Drive, Marietta, GA 30060, Mail Stop MA-202
Phone: 770-528-4461 Foundation@ChattahoocheeTech.edu
Chattahoochee Tech Foundation (Tax ID 58-1684206) is a 501(c)(3) and your gift is tax-deductible to the extent of the law.
If you have any questions, please call 770-528-4461 or email Foundation@ChattahoocheeTech.edu
.
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