Payroll Deduction Form 2025

Employee Campaign 2025 Payroll Deduction Form

Thank you for participating in our 2025 Employee Giving Campaign “Your Gifts Power the Future”!

MM slash DD slash YYYY
Name(Required)
Personal Mailing Address(Required)

Donation Information

Number of Pay Periods | Please select the number of pay periods to divide the gift. You can choose a one-time deduction from a single paycheck, or divide it up to 24/26 pay periods.(Required)
Designations | Please indicate your designation(s) below. If you select more than one designation, please complete "Special Instructions" below.(Required)
Sprout Society