Employee Payroll Deduction

Thank you for your support. Donations from Central Piedmont faculty and staff are especially meaningful and convey a powerful message to other funders and grant providers. Your gift, whatever the amount, is greatly appreciated.
 
Please complete the form below to authorize your payroll deduction donation. Forms submitted after the 12th day of the month may be processed the following month.

* Indicates required field

Contact Details

Employee ID *
First Name *
Last Name *
Email *
Phone *
Campus *
Employee Status *

Donation Details

Donation Amount (per withdrawal)
$
Donation Occurrence *
*Forms submitted after the 12th day of the month may be processed the following month.
End Date for Deduction
*If you selected monthly deduction, please list your desired end date for the deduction. If you wish to continue the deduction without an end date, please type "indefinite."
Gift Designation *
If Other, please specify Department/Program
*If you would like to split your donation between funds, please contact us at info@cpccfoundation.org.

Honor/Memorial Giving

My gift is...
Name

Whom Should We Notify of Your Honor/Memorial Gift?

Name to Notify
Address
City
State
Zip