Payroll and Pension Deduction Form

Current: Payroll Form » Review » Finish

Gift Information

Gift Type

Payment Frequency:

Gift Amount Required Field

For Single Gifts, enter total. For Recurring/Pledges, enter the monthly/bi-weekly deduction.

Duration of Pledge Payments

Please Select an Area to Support Required Field

Please Select a Fund Required Field

If you wish divide your gift evenly between two areas of support, please make a second selection:

Please Select a Fund

If you wish to support more than two areas, please use the comments section below to get in touch with us.

If Selected 'Other' above, please enter the fund name:

Contact Information

First Name: Required Field

Last Name: Required Field

Email:

My Waterloo Affiliation: Required Field

My Waterloo Affiliation: Faculty/Staff
Retiree

Department:

WatIAM:

Home Address 1: Required Field

Home Address 2:

Home Address 3:

City:

Province/State: Required Field

Postal Code: Required Field

Country:

Home Phone Number:

Are you interested in making a planned gift?

I have included a gift to Waterloo in my will or another asset e.g. life insurance.

Please send me information about making a gift in my will.

Is this a joint gift with your partner/spouse?

I am making this gift on behalf of me and my partner/spouse.

Partner/Spouse First Name:

Partner/Spouse Last Name:

Is this gift in memory or honour of someone special?

Tribute Type:

First and Last Name of Deceased or Honouree:

Do you have any comments?

Comments: