LOOKING TO GIVE BACK TO HOLMES?
The Foundation encourages you to participate in the payroll deduction option by donating to
the HCC Foundation. Completing this form and returning it to the Payroll Analyst will ensure
your support and dedication to Holmes Community College.
Name: ______________________________________________________________ H No. __________________
I pledge payroll deduction of $_________ monthly or $__________ biweekly to the HCC Foundation.
Effective Date: ____________________________________________________________
Indicate how you wish for your contribution to be used:
_____ UNRESTRICTED (to be used for the foundation’s greatest need)
_____ Department/Program/Club: _____________________________________________________________
Signature _________________________________________________________________ Date_______________
Please return form to:
Terrell Hammett, Payroll Analyst
Henry B. McClellan Administration Building, Goodman Campus
The Foundation thanks you for your commitment to Holmes Community College.
Holmes Community College does not discriminate on the basis of race, color, religion, national origin, gender, dis-
ability, or age in its educational programs and activities, employment or admissions. The following person has been
designated to handle inquiries and grievances regarding non-discrimination, compliance policies, and procedures
for the College: Compliance Officer, 662-472-9429. Written inquiries may be emailed to: firstname.lastname@example.org or
mailed to: Compliance Office, 412 W. Ridgeland Avenue, Ridgeland, MS 39157.
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