I wish to make a gift of $ per check (minimum $5/mo.)to .
By submitting this form electronically and typing my full name, I authorize a deduction in the amount shown above to be withheld from my pay in accordance with the State Salary and Annuity Withholding Act to be remitted to the University of Illinois Foundation (payee code no. 40).
Please select AgreeDisagree
12 months 36 months until I request termination
months or terminate on
INITIATES my automatic gift support through payroll deduction
CHANGES the amount of my gift from that presently being withheld
TERMINATES my payroll deduction gift support
is for JOINT CREDIT with spouse or life partner
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