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Payroll Deduction Authorization Form
Payroll Deduction Authorization Form
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Payroll Deduction Authorization Form
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Payroll Deduction Authorization Form
This form is for authorization of payroll deduction for Denmark Technical College. I understand that this deduction will begin immediately and continue until I provide other instructions to the Payroll Department to cancel or make changes. By submitting this form, I hereby authorize Denmark Technical College's Payroll Department to deduct the amount indicated below, from my paycheck, each pay period, as a donation. Cash donations are also accepted and may be submitted to the Cashier or any personnel in the Business Office, at Denmark Technical College. We thank you for your support of our College.
Email
(Required)
Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
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Northern Mariana Islands
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Virginia
Washington
West Virginia
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Employee ID #
(Required)
Division
(Required)
Academic Affairs
Fiscal Affairs
Institutional Advancement and Effectiveness
Office of the President
Student Affairs
Other
Division: Other
Type of Payroll Deduction
(Required)
Payroll Deduction Pledge
One-Time Donation
Payroll Deduction and Pledge for bi-weekly deductions: You will pledge to enroll into payroll deductions, until you notify the Payroll Department, in writing of the decision to decrease, increase, or stop. No amount is too small.
$10 per pay period ($240 a year)
$20 per pay period ($480 a year)
$50 per pay period ($1,200 a year)
$100 per pay period ($2,400 a year)
Donation Amount
$25
$50
$75
$100
$250
$500
Other
Other Donation Amount
Scholarships and Giving Campaign
$76 for DTC's 76th Anniversary
1947 Club Giving Campaign
Athletic Department Scholarship
Bamberg-Hampton Alumni Chapter Scholarship
Basketball Funds
Beautification and Improvement Project
Denmark Technical College Legacy Gala Scholarship
Frazier/Scholar Training Scholarship
General Fund
Giving Back to Greatness Campaign
Mr. Robert L. Bonnette, Sr. Scholarship
Panther Pathways Pantry Project
President's Honor College Scholarship
Student Government Association Scholarship
Student Services Support
Willie B. Caldwell Endowment Scholarship
W.R. Canty Scholarship
Gala Tickets
Homecoming Tickets
Other
Other: Scholarships and Giving Campaign
Total
Credit Card
Card Details
Cardholder Name
Δ
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