Payroll Deduction Form

Name*
First Last
Department*
Division*
Extension*
Email*
Please choose a fund from "Giving Options" or select "Other" and enter fund name.
Giving Options*
Other Fund
Amount Per Check*
Please consider choosing Recurring Giving to make an even greater impact. (You can also select to make a one-time donation from a single paycheck or select from the options available.) If your desired "Pay Period" option is not listed, please email foundation@cod.org with your preference.
Number of Pay Periods*
Anonymous
- I would like this gift to be anonymous
Authorization: By submitting this form, I authorize the action above in the amount and frequency indicated. I understand that if I selected Continuous Giving, the gift will continue at the amount and frequency indicated until I request a change in writing to the COD Foundation at foundation@codfound.org.
Phone
This field is for validation purposes and should be left unchanged.