Community Campaign - Payroll Deduction

Community Campaign - Payroll Deduction

If you have any questions, please contact Sharline Doss at sdoss@wlu.ca or x3896

Employee ID Number:
required
Department:
First Name:
required
Last Name:
required
Primary Email:
I am a Laurier graduate:
From my pay, please deduct my donation in equal amounts of



Other amount:
Continue this deduction...

Indicate the total contribution amount here:
I would like to designate my contribution to the following:
If OTHER designation is chosen, please specify here:
I wish my gift to remain anonymous
I spoke to a Laurier staff member about this gift:
Staff Member Name:
Share Recognition with my Spouse/Partner
Please give equal recognition for this gift to my spouse/partner
Spouse/Partner Full Name:
Your spouse/partner's company may have a matching gift program. If it does, your gift to Laurier may be doubled or even tripled! 
Please contact me about having this gift matched through my spouse/partner's company
I would like to make this gift in honour of someone special
Tribute Type:
Occasion:
This gift is in honour memory of (please provide full name):
This information is collected under the authority of the Wilfrid Laurier University Act for the purposes of processing your donation, keeping you informed of our programs and services, and for fundraising for Wilfrid Laurier University. Any information we receive from you will be kept private. We will not sell, rent or trade your information with anyone outside Wilfrid Laurier University. If you have any questions about how we use your information, please contact Duncan Malcolm, Director: Advancement Services, at dmalcolm@wlu.ca or 519.884.0710 ext. 3866.