PAYROLL CHECK TO BE MAILED
COMPLETE ENTIRE FORM
Pay Date: _________________________ I.D. Number: ________________________________
(One form per paycheck)
Employee Class: Student ____
(Check One) Staff ____
Faculty ____
Last Name: _________________________ First Name: ____________________________
Address: ____________________________________
City: ____________________________________
State/Province: ____________________________________
Country: ____________________________________
(If outside the US)
Zip/Postal Code: ________________
Whittier E-mail:________________________________________________________________
Whittier College is not responsible for any lost/damaged check(s). If a check needs replacement or is
lost, please contact payroll immediately at 562-907-4200 ext 4272 or ext 4546.
Signature: _______________________________ Date: ______________________
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signature
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