Payroll Deduction Form - Montgomery College
473710-2603500 EMPLOYEE CHARITABLE DONATION FORM Yes! I want to support Montgomery College students! I want to designate my gift to the following area:___ Annual Fund (Areas of greatest need)___ Global Humanities Institute (Challenge grant) ___ Achieving Collegiate Excellence and Success (Scholarships for students under-represented in higher education)___ General Scholarships___ Dreamers Act Scholars Fund (Scholarships for students impacted by the Maryland Dream Act)___ Innovation Fund (Funds new and unique programs to enhance education.)___ Student Emergency Assistance___ Employee Emergency Assistance___ Other (Please specify below)__________________________________Every Gift Counts! For Example—$50 per pay period can help cover tuition and fees.$25 per pay period can help cover books.$15 per pay period can help cover materials.Endow a Scholarship in Your Name.*PAYROLL DEDUCTION□ Amount per pay period $__________ Total Annual Gift Amount $________ Faculty (x 20 pay periods) Staff (x 26 pay periods) Begin deductions_____________2016 (Month) □ Continue deductions until I notify MCF.Print Name__________________________________M#__________ Dept/Unit____________________□ Faculty□ StaffSignature________________________ Date______ (Required)ONE-TIME GIFT□ Check Amount $______ (Make payable to Montgomery College Foundation.)□ Credit CardTo make a secure credit card donation, go to montgomerycollege.edu/online giving ORCall Noah Saposnik x74108.Print Name________________________________M#_________ Dept/Unit_____________________□ Faculty□ StaffSignature________________________ Date______ (Required)□ Please send information on estate planning or planned gifts.Thank You for Your Support! Please sign and return form to: Montgomery College Foundation, 40 W. Gude Drive, Suite 110, Rockville, MD 20850, Attention: Noah Saposnik, Annual Fund Manager OR scan and email: noah.saposnik@montgomerycollege.edu x74108.*To endow a named scholarship, contact Francene Walker, CFRE, Major and Planned Gifts Director: x77491 francene.walker@montgomerycollege.edu. The Montgomery College Foundation is a charitable organization. All contributions are tax-deductible to the extent allowed by law under the Foundation’s 501(c)(3) IRS tax status.Updated 1/23/15 ................
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