Barry Annual Fund: Payroll Deduction Pledge

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Enter Your Information

First Name

Middle Name

Last Name

Preferred Email

Preferred Address Information

Preferred Address

Apt/Unit/Suite

City

State

-- Select One --AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces - AmericasArmed Forces - Europe/Africa/CanadaArmed Forces - PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

ZIP Code

Phone

Employment Information

Department

Title

Employee Status

• Non-Exempt (I get paid every 2 weeks)
• Exempt (I get paid on the 15th and 30th)

Gift Details

Donor Status

• I am a new donor
• I am a current donor (change current deduction)

Apply gift to

• Barry's Greatest Need
• General Scholarships
• Athletics - The BUC Club
• Law School
  • New St. Rose of Lima Chapel
  • Prof. Stanley Talcott Scholarship
  • Faculty Enrichment
  • Mitchell Frank Scholarship Fund
  • Unrestricted
  • Other
• School of Podiatric Medicine
• Other

Deduction Method

Contribution Frequency

• Continuous deduction from each paycheck ($2.00 minimum)
• One time from paycheck

 

Suggested Levels

Suggested Levels	Non-Exempt Payroll Deduction	Exempt Payroll Deduction
$50.00	$1.93	$2.09
$75.00	$2.89	$3.13
$100.00	$3.85	$4.17
$150.00	$5.77	$6.25
$250.00	$9.62	$10.42
$500.00	$19.24	$20.84
$750.00	$28.85	$31.25
$1,000.00	$38.47	$41.67
$1,500.00	$57.70	$62.50
$2,500.00	$96.16	$104.17
$5,000.00	$192.31	$208.34

Amount

$

Based on your pledge your yearly contribution is

$

 

Thank you for your gift!

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