Payroll Deduction Form

Name*
First Last
Department*
Extension*
Email*
Please indicate your preference below. There are many funds from which to choose, including more than 140 scholarship funds and nearly 50 different program funds! If you want to support multiple funds, select "other" and indicate your allocation.
Giving Options*
Total Donation*
Please select the number of pay periods to divide the gift. You can choose a one-time deduction from a single paycheck, divide it up to 26 pay periods, or continue until you notify us.
Number of Pay Periods*
Authorization: By submitting this form, I authorize the action above in the amount and frequency indicated. I understand that if I selected a recurring donation, the gift will continue at the amount and frequency indicated until I request a change in writing to either the COD Foundation or the COD payroll department.
Email
This field is for validation purposes and should be left unchanged.