Monthly Payroll Deduction for Western Faculty & Staff

 

No one knows Western's strengths - and current needs - like you, our faculty and staff. By supporting the University through payroll deduction, you demonstrate to others the value you place on this institution not just as an employer but as an
important contributor to society.

Faculty and staff give to Western in a variety of ways for unique reasons. Every gift - regardless of size - makes a difference
to the University.

 

Please note: in each section below an asterisk (*) indicates a required field.

 


About You

  Please provide the following information:

*

Name:

 

 

 

 

       

*

*

 

*

City/Prov/Postal

 

    

*

*

 

What's this?

*  


 
Question - Not Required - In addition to being a Western faculty or staff member, do you have any other relationship to the University? Please check all that apply.

   


 

(Maximum response 255 chars, approx. 5 rows of text)

 


Your Western Contact Information

*

(Maximum response 255 chars, approx. 5 rows of text)

*

(Maximum response 255 chars, approx. 5 rows of text)

*  


*  


 


Your Gift

*  


*


*

(Maximum response 255 chars, approx. 5 rows of text)

 
Question - Not Required - I want my gift to remain anonymous.

 

(Maximum response 255 chars, approx. 5 rows of text)

 


Tribute Information

*
Question - Required - Is this gift in honour or memory?

   


 

(Maximum response 255 chars, approx. 5 rows of text)

 

   Please leave this field empty