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Baldwin Wallace University Annual Giving
EMPLOYEE BI-WEEKLY PAYROLL DEDUCTION REQUEST
First Name
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Last Name
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Phone Number
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Department
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Email Address
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SSN# (last 4 digits ONLY)
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Enroll in new payroll deduction:
Amount deducted per paycheck:
OR
I'm already enrolled and would like to increase my deduction:
My NEW TOTAL deduction per paycheck will be:
I'd like my gift to be designated for the following purpose:
select one
The Fund for BW
select one
Other Fund:
Submitting this form takes place of a signature and confirms agreement for funds to be deducted from your paycheck.
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I agree.
Please continue my deductions:
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Until I request it to stop.
Until the date noted below (mm/dd/yyyy).
Until the date noted below (mm/dd/yyyy).
Questions? Please contact the Annual Giving Office at 440-826-2135 or bwannual@bw.edu.