Employee Deduction Authorization

"*" indicates required fields

Please complete this form and return it to the Office of University Advancement. Payroll deductions will continue until you elect to stop the deductions with written instructions to the Office of University Advancement. If you wish to update your gift amount or gift designation, please submit a new employee deduction authorization form. You will receive an acknowledgment letter at the end of the calendar year for the total donation amount via payroll deduction for the year. If you have any questions, please contact the Office of University Advancement by emailing advancement@seu.edu.

Employee Name*

First Last

Employee ID Number*

Employee Mailing Address*

Street Address Address Line 2 City State ZIP Code

The Office of University Advancement will mail donor acknowledgements and tax receipts to this address.

Employee Email*

Employee Phone Number*

Position at SEU*

Gift Designation*

Academics

Annual Fund

Athletics

Student Development

Other

Specify College*

Please Specify*

Total Deduction*

If you have checked multiple boxes, please include the breakdown on how much to allocate to each fund.

Phone

This field is for validation purposes and should be left unchanged.

Employee Deduction Authorization

1000 Longfellow Blvd. Lakeland, FL 33801 | 800.667.5455