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University
of Victoria
Giving to UVic
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Giving Tuesday Payroll Donation Form
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To make your gift by payroll deduction, please fill out the following form:
*
Gift per paycheque
$5 ($120/year)
$10 ($240/year)
$25 ($600/year)
$50 ($1,200/year)
Other (please specify below)
*
*
Gift designation
GivingTuesday Fund
Other (please specify below)
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Employee number
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First name
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Last name
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Address
*
City
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Province
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Postal code
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Phone number
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Email
*
Your payroll deduction donations will continue until you decide to change or cancel your support. If you would like your contributions to end at a specific time, please indicate the date in the box below.
*
Payroll deduction end date (optional)
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Additional information (optional)
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I wish to remain anonymous
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Please send me information about making a gift to UVic in my will
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Please send me information on gifts of publicly traded securities
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