Payroll Deduction Step 1 of 3 33% Thank you for your support through payroll deduction. Please read the information below before completing this form. Payroll deduction installments must be at least $2.00 All deductions will occur on a bi-weekly basis You will have the option to give for six months, nine months, one year, three years or five years Name(Required) First Last Email(Required) Donation OptionsDonation Per Pay Period(Required) Installment Schedule(Required) Six months (12 installments) Nine months (18 installments) One year (26 installments) Three years (78 installments) Five years (130 installments) You can invest in our students, our people, and our mission by joining the Spire Society! If you would like to become a member, please do the following: 1) Choose the three year installment schedule option; 2) Input $38.46 or more for your donation amount per pay period for a total minimum donation of $1,000 per year for three years, and 3) Designate your gift to one or more annual fund designations below (non-annual fund designations are not eligible for Spire Society membership). Thank you for your investment! Spire Membership Yes, I want to join Spire Society!Please indicate how you would like to be recognized on the Spire Society donor roll: Ex. John A. '79 and Julie B. Smith Please indicate the area(s) you wish to support (up to five) below. Payments will be split evenly among all selected Gift Designations(Required) Area of Greatest Need Fisher Fund for Financial Aid School of Arts and Sciences Annual Fund School of Business Annual Fund Wegmans School of Nursing Annual Fund Wegmans School of Pharmacy Annual Fund Ralph C. Wilson, Jr. School of Education Annual Fund Athletics Annual Fund Lavery Library Annual Fund Student Life Annual Fund Presidential Initiatives Fund Other Other designation: Consent(Required) This information is correct.I have reviewed the above information and have verified that it is correct. Personal InformationPreferred First Name Current Job Title Department Please indicate your terms of employment at Fisher:(Required) 9 month 10 month 12 month This will assist us in setting up payroll deductions for 9- or 10-month employees if installments need to resume after a break in payroll status (after summer months for example) Δ
