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| Your gift must be received prior to the 7th of the month in order for payroll deduction to begin in the same month. |
| I would like to pledge my support of Temple University with a gift of $: |
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| Choose the area of the university you would like to support: |
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| Choose a specific fund or program: |
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| Other (please specify): |
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| Payroll Deduction Options: |
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If you would like to fulfill your pledge through equal deductions over several paychecks, please complete the section below:
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| Each pay period, please deduct $: |
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| Please begin my payroll deduction in |
| Month: |
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| Year: |
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| Please end my payroll deduction in |
| Month: |
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| Year: |
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Payroll deduction pledges cannot exceed 5 years.
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| I am paid: |
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Employee Information
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| First Name |
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| Last Name |
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| TUid |
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| Department |
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| Title |
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| Email |
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| Phone Number: |
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| Business Phone: |
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| Address Line 1: |
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| Address 2: |
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| City: |
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| State: |
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| Zip: |
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