EmailMeForm
Payroll Deduction Authorization
First Name
*
Last Name
*
E-mail Address:
*
I authorize the State System of Higher Education to:
*
Start
Stop
Change
Bi-weekly payroll deductions to the Lock Haven University Foundation
I would like to donate to the following area:
Gift Designation:
*
Biweekly Deduction Amount:
*
I would like to help impact more than one area:
Gift Designation:
Biweekly Deduction Amount:
Gift Designation:
Biweekly Deduction Amount:
Signature
Clear