Set Up Your Payroll Deduction

Set Up Your Payroll Deduction

For assistance with this form, email Jeremy Smith at smit8j7@ucmail.uc.edu
Employee Name*

First NameLast Name
My primary employer is*

University of CincinnatiUC Foundation
M Number (Employee ID)*
I am Paid:*

Bi-WeeklyMonthly
Which organizations would you like to support? (check all that apply)*

University of CincinnatiArtsWaveCommunity SharesUnited Way

Your Gift to the University of Cincinnati

Gifts to any UC designation count towards our Faculty & Staff campaign.
Which College/Unit would you like to support?
Gift to UC
Please designate my gift to the following fund:
If you do not provide a designation, your gift will be used to support the greatest need.
Amount to be Deducted per Pay Period to Support UC
Desired Number of Pay Periods
Suggested Periods
Total Pledge to this UC Fund
Gift to UC
Add Another Gift to UC

YesNo
Which College/Unit would you like to support?
Second Gift to UC
Please designate my gift to the following fund:
If you do not provide a designation, your gift will be used to support the greatest need.
Amount to be Deducted per Pay Period to Support UC (2)
Total Pledge to this UC Fund
Second Gift to UC
Add Another Gift to UC

YesNo
Which College/Unit would you like to support?
Third Gift to UC
Please designate my gift to the following fund:
If you do not provide a designation, your gift will be used to support the greatest need.
Amount to be Deducted per Pay Period to Support UC (3)
Total Pledge to this UC Fund
Third Gift to UC
When should this payroll deduction begin?*

Please start my payroll deduction in the next available pay period.I have an existing payroll deduction pledge. Please start this pledge after the final installment.
UC Honor Roll*

Please include my/our name in relevant UC Honor Roll publicationsI/we wish to remain anonymous. Please do not publish our my/our name.

Your Gift to United Way
Amount to be Deducted per Pay Period to Support United Way
Desired Number of Pay Periods
Total Pledge to United Way
Would you like to designate your gift to a specific partner organization?

YesNo
Which partner organization would you like to support?

Your Gift to Community Shares
Amount to be Deducted per Pay Period to Support Community Shares
Desired Number of Pay Periods
Total Pledge to Community Shares
Community Shares Gift Designation

Community Shares Annual Fund (supports our work on social justice in the community)Undesignated Community Shares Fund (shared between all member charities)Designated Community Shares Member Charity (please select)
Community Shares Member Charity to Support

Your Gift to the University of Cincinnati