Ferris

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Faculty and Staff Payroll Deduction Form

First Name

Last Name

Please enter your eight digit Banner ID

Campus Address

Campus or Cell Phone

Select Gift Designation

Please note: gifts to an established scholarship endowment of at least $1,000 annually, by an individual or group, will be matched 100% by the Ferris Futures Scholarship Challenge.

Guest Names and Dietary Restrictions (if known)

255 character limit

0 / 255

Use the box below to describe specific "Athletic Club/Team" or "Other Designation" selected above. If you wish to give to an Athletic Club Membership, please specify benefit package or opt out of all benefits by clicking the box below.

255 character limit

0 / 255

Check here if you wish to decline Athletic Club Membership benefits (if applicable).

Deduction Option

Recurring Deduction (per pay amount)

Enter amount for one-time payroll deduction

START DATE: (Please note, depending on the submit date of your request, deduction periods may need to be adjusted.)

END DATE: (No end date is required if this is a continuing payroll deduction.)

Please provide additional information below regarding payment options and schedules, memorial/honorarium information, etc. If using this form for One Day for Dawgs campaign, please enter “ODFD” and the Team Name you are supporting below.

255 character limit

0 / 255

I authorize Ferris State University to process this deduction according to amount and time period listed above. If no end date was entered, I authorize deductions to continue, until I notify Advancement Services or the Payroll Department in writing.

$0.00

Select Gift Designation

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Amount Per-Pay