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Faculty and Staff Payroll Deduction Commitment Form
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Faculty and Staff Payroll Deduction Commitment Form
Personal Information
Siena ID:
Title (Mr., Ms., Dr., etc.):
First Name:
Last Name:
Suffix (Jr., Sr., etc.):
Primary Email:
Email
Confirm
Your password must have
each of the above components
and be at least 8 characters.
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Low
Moderate
Secure
Very Secure
Re-type your password.
Re-type your email.
Please verify your input by typing it again.
Passwords do not match!
Emails do not match!
Inputs do not match!
Passwords match!
Emails match!
Inputs match!
Business Phone Number:
Department:
Position:
Pledge Information
New/Existing Deduction:
Please Choose
New Payroll Deduction
Add to my existing Payroll Deduction
Replace my existing Payroll Deduction
Pay Period Schedule:
Please Choose
Admin/Faculty (24 Pay Periods)
Staff (26 Pay Periods)
Amount per pay period:
$
Choose your area of Support
Choose your area of Support
Annual Fund | President's Discretionary Fund
Annual Fund | Academic Programs
Annual Fund | Facilities and Grounds
Annual Fund | Financial Aid
Other
If you selected other, please specify where you would like to allocate your gift:
Length of Deduction:
Please Choose
# of Pay Periods
# of Years
Indefinite
# of Years/Pay Periods:
Please Choose
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Please Choose
1
2
3
4
5
Comments:
Cancellation Policy
Cancellation Policy:
If deduction period is indicated as indefinite, you recognize that this payroll deduction will stay in effect until such a time that you change it via formal notification to Human Resources and Development.
Click here
to cancel your payroll deduction.
I agree
Confirmation
You are about to submit your payroll deduction form over our secure server. Please check your information carefully for accuracy, and then click "Submit."
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