Faculty and Staff Payroll Deduction Official Form

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Faculty and Staff Giving

Thank you for considering a payroll donation in support of our students, and for all that you do for our campus community. Support from MCLA faculty and staff is invaluable and inspiring, and we are deeply grateful. If you have any questions, please contact Taylor Woodward at taylor.woodward@mcla.edu

CONTACT INFO

First Name

Last Name

Department

I authorize the Massachusetts College of Liberal Arts to deduct the following amount from my bi-weekly salary to be contributed to the following MCLA Foundation fund(s) beginning in the next pay period. Please note that this request will supersede any donation payroll deductions currently on file. Payroll deductions will continue until stopped by the employee, which can be done by emailing advancement@mcla.edu.

Please fill out the form below and indicate how much you would like deducted each pay period.

Fund 1

Amount 1

Fund 2

Amount 2

Fund 3

Amount 3

Comments

Please review the information you are submitting. It will be submitted to our Advancement and HR records. The accuracy of your entry is important. For questions about this form, please contact advancement@mcla.edu.

(Office Use Only)

Date sent to HR

Maintenance Code

Add

Change

Delete

No Change

per pay period to the Restricted Account 720126 21187101-5

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