Faculty and Staff Payroll Deduction Form

Personal Information

First Name:

Last Name:

Faculty/Staff ID:

Email:

Changes to Existing Payroll Deduction

Please explain changes in the box:

New Payroll Deduction Gift Information

Let us know which area(s) you’d like to support and the corresponding dollar amount for your deduction.

For Example:

Valpo Fund: $20
Arts and Sciences Dean's Fund: $5
= A total of $25 deducted per pay period

Valpo Fund*: $

*The Valpo Fund: The Valpo Fund makes the Valpo experience possible. Your generosity enables us to respond quickly and effectively to various needs across campus – foster innovative improvements to our historic buildings and facilities, evoke hope through student scholarships, and inspire opportunities for learning and spiritual growth.

Arts and Sciences Dean's Fund: $

Business Dean's Fund: $

Christ College Dean's Fund: $

Christopher Center Library Dean's Fund: $

Engineering Dean's Fund: $

Guild Fund: $

Nursing Dean's Fund: $

Athletics: $

Please specify the Valpo Athletics team/program to direct your deduction to:

Other: $

'Other' comments:

Total deduction selected:

Giving Societies

Questions about whether your deduction qualifies you for inclusion in of our giving societies? Click here to learn more.

Additional Information

By submitting this form, you are authorizing this deduction. However, you have the right to discontinue this deduction at any time. If you have any questions please call Jessica Fitman, Associate Director of Advancement Services, at ext. 6876 or email advancement.services@valpo.edu.

Please allow up to two weeks for your first deduction to be processed.