Employee Survey and Payroll Contribution Deduction Form

Employee Survey and Payroll Contribution Deduction Form

Complete the Employee Survey to update your information on file in the Advancement Office.
Personal Information
Full Name *

Prefix First Name Middle Name Last Name Suffix
E-mail *
Birth Date

Month Day Year
Marital Status
Relationship to Greenville College (Check All That Apply)

Alum Non-Alum Non-Grad Alum Employee GOAL Graduate Other

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Alt. Phone Number

- Area Code Phone Number
Spouse's Name

First Name Last Name
Spouse's Date of Birth

- Month - Day Year
Child's Name

First Name Last Name
Child's Date of Birth

- Month - Day Year
Child's Name

First Name Last Name
Child's Date of Birth

- Month - Day Year
Child's Name

First Name Last Name
Child's Date of Birth

- Month - Day Year
Child's Name

First Name Last Name
Child's Date of Birth

- Month - Day Year
NOTE: This information is being requested by the Advancement Office for internal use only in order to communicate periodically by mail and phone with College employees for the purposes of information, alumni relations, and fundraising. If you do not wish to receive such communications, please check the appropriate boxes below.
Communications from the Advancement Office

Do not contact me by phone Do not send me mailings other than The Record or alumni magazine Never send me any mail for any reason
Authorization to Initiate or Revise Payroll Contribution Deduction

Complete this section if you wish to gift funds to the College through a payroll deduction
I do not wish to participate in the Payroll Contribution Deduction at this time.
I authorize Greenville College to deduct from each check the following amount as a contribution to the College. This deduction will begin with the first check after the date received. (Note: the deduction amount designated is per pay period, the College payroll process is semi-monthly with 24 pay periods per year.)

This authorization will replace any current deduction on file.
Contribution Deduction Amount (please specify project account designation below)
ex. $25
Contribution Deduction To (Designate the specific project account(s))
ex. Annual Fund
Start Date of Deduction (if different than the first payroll check after the date received)

- Month - Day Year
End Date of Deduction (if applicable)

- Month - Day Year
I agree to the contribution deduction amount above and I may change or discontinue this payroll deduction at any time and it will be processed with my first check possible after receipt by payroll.
Comments:
Should be Empty:

Employee Survey and Payroll Contribution Deduction Form

Personal Information

Authorization to Initiate or Revise Payroll Contribution Deduction