I hereby authorize payroll to make the above listed payroll deductions from my salaries and wages for philanthropic gifts of my choice identified on this form. This authorization will remain in effect until cancelled in writing by myself or by payroll.

*This payroll deduction form replaces any current UNLV designated payroll giving agreements in place for the named employee above.

I certify that I am an employee of the University of Nevada, Las Vegas and understand that termination of employment will cancel all deductions made under this authorization.

Signed: Date:

Dr./Mr./Mrs./Ms. First Name Last Name

My e-mail address is:

Phone: ( )

College/Dept.: Campus Mail Stop:

Campus Phone: (702)

Home Address: City State Zip

Spouse/Partner:

Yes, I would like to make a payroll deduction donation

ANNUAL FUND GIFT

MY GIFT WILL SUPPORT:Name of College, School, Fund or Department

Amount per pay period: $

Amount per pay period: $

MY GIFT WILL SUPPORT:Name of College, School, Fund or Department

Amount per pay period: $

Classified Faculty Administrative Faculty

Employee Payroll Deduction Authorization Form

EMP. ID#: Gift(s) Total per pay period:

Support UNLV through Employee Payroll DeductionAnnual Giving

Athletics: Rebel Athletic Fund

Barrick Museum

Center for Autism

Classified Staff Dependent’s Scholarship

Classified Staff Development Fund

Debate League

General Scholarship Fund

Graduate Assistantships

Graduate College

Healthy Homes Initiative

The Huntridge Teen Dental Clinic

Institute for Children's Research and Policy

KUNV Radio

Libraries

Marriage & Family Therapy

Nursing Skills Lab

Oral History Project

Renewable Energy Program

Sgt. Clint Ferin Dental Clinic

Science Bowl

Student Affairs

Thomas & Mack Legal Clinic

UNLV Preschool

UNLV Cares Food Pantry

Veteran Student Services

For the past 57 years faculty and staff have understood firsthand the value of investing in UNLV and our mission. Whatever your position may be, you play an important role in educating the brightest young minds and strengthening the cultural and intellectual fabric of our community.

How to Make Your Gift:

① Choose your favorite department, division, or fund (like Annual giving) to support

② Share your name, contact information, and signature to complete the form

③ Drop the form off in person or send it by mail to the Foundations Building (Mail Stop 1006)

④ Breathe deeply and smile as the gratitude from countless others washes over you

⑤ Your payroll deduction gift will begin within one to two payroll cycles

To make a one-time gift, visit us at www.unlv.edu/foundation/give-online

Every year, 1 in 5 faculty and sta� make a gi� in support of UNLV students.

Did you know?Did you know?