Payroll Deduction

Employee Information

First Name: Required Field

Last Name: Required Field

Official UAB Email: Required Field

Blazer ID: Required Field

Pay Category: Required Field

Pay Schedule:

Pay Schedule: Monthly
Biweekly

This gift should remain anonymous

Area of Support

Please designate my gift to: Required Field

One Time Gift

Please complete this section if you are an employee of UAB and wish to make a one-time gift via UAB payroll deduction.

I would like to make a
one-time gift of:

Please deduct my one-time gift on:
Month/Year: (MM/YYYY)

Monthly Gift (automatic monthly renewal)

Provide us with the total amount to be deducted from each paycheck, and indicate the start of this deduction.

I would like to show my support with
a monthly deduction of:

Please BEGIN my deductions on:
Month/Year (MM/YYYY):

Pledge Installments (finite number of payments)

Provide us with the total amount to be pledged, and indicate the duration of this pledge.

I would like to show my support with a total pledge of:

Please BEGIN my pledge payments on:
Month/Year (MM/YYYY):

Duration of pledge
(2-60 months):

Please watch for an email immediately following the completion of this form for confirmation of your payroll deduction.

For questions, please contact UAB Gift and Biographical Records by phone at 205.934.7242 or via email at gifts@uab.edu