University of Montevallo - Alumni & Friends

Alumni & Friends

Copyright © 1994-2013, University of Montevallo, Montevallo, AL 35115 _· (205) 665-6000. EOE, All Rights Reserved.
Comments and Questions

Name*:
M #*
Station number*:
Home address:
	City	State	Zip
Home telephone:

Total amount of gift*:

Gift payment options:
I would like to make a gift for the 2011-2012 annual fund campaign. Please deduct $ per month. First installment must be made by the 20th of the previous month for payroll processing. For example, deduction form must be received by Nov. 20 to begin in December.
	Begin payroll deduction in: September October November December January February March April May June July August

I would like to make a recurring gift of $ per month. (Gift will be of equal installments per month and will be deducted until University Advancement is notified to stop deduction).

Use my gift to support:
My gift is in honor of:
My gift is in memory of:
Notification of gift in honor/memory should be sent to:

I understand that upon receipt of this form in University Advancement, the University of Montevallo Office of Personnel Services will be authorized to deduct from my pay the installments I have designated.