Employee Giving Form

Name
First Last
Campus
Position
Please check one box below after prayerful consideration:
- I am a new payroll deduction enrollee
- I am changing my designation or deduction
- I already give through payroll deduction
- I will make an annual gift outside of payroll deduction
- I am unable to make a gift at this time but will pray for the Annual Fund
Giving Purpose (please select one)
- Capital Campaign
- Kentucky Annual Fund (ES, SW, RC)
- Indiana Annual Fund
I authorize Christian Academy School System to deduct the following amount from each paycheck until I cancel or adjust the arrangement. I understand the payment can be stopped anytime, but previous deductions will not be refunded. (Enter total giving per pay period)
Signature
Date
MM slash DD slash YYYY