Giving - Payroll Deduction

Payroll Deduction

First Name

Last Name

Address 1:

Address 2:

City:

State:

Zip:

Department:

Designation:

If you do not see your gift designation listed above, please contact giving@thechicagoschool.edu.

Additional notes (e.g. 'this gift is in memory of ...').

Schedule:

Date Payroll Deduction is to Begin:

Date Payroll Deduction Should End

Total Amount if One Time Gift

Total Annual Contribution

I authorize my employer to deduct the above amount from my paycheck.

I agree to the above statement.