Yes, I want to be a part of
Helping Our Own
Name: ___________________________________________
Department: ______________________________________
Campus Address: __________________________________
Campus Phone: ___________________________________
I authorize the payment of my pledge to Saint Lois University through payroll
deduction as shown below:
Total Pledge amount: $ _______________________
Monthly deduction: $ ________________________
Bi-weekly deduction: $ _______________________
Perpetual Payroll Deduction. I authorize these deductions to continue until
I cancel them through a written notification. (By checking this box, no renewal is necessary.)
Banner ID #: ____________________________________________
(As indicated on your employee ID card)
Signature: ______________________________________________
(Required for all payroll deductions)
Date: _________________________________________________
I want to help now. Enclosed is my gift of $ ________________. (Make checks
payable to “SLU Helping Our Own.”)
Please return to SLU Helping Our Own, Mission and Ministry, DuBourg
Hall Room 211, Frost Campus