FMU Annual Fund Appeal for Faculty and Staff / Contribution Form
Fields marked by * are required.
Title: Name: *
University Department/Division: *
Office Number: *
Home Address: *
Email Address: *

PAYROLL DEDUCTION

Please choose the correct option:

  • New Payroll Donor
  • Changing the dollar amount or designation
Please designate my gift(s) to the following fund(s): (Lion Fund (Annual Giving) Drive, Presidential Gala, Athletics, Academics Support and/or General Scholarship – Payments can be spread out through the end of December 2015)

  • Lion Fund Drive
  • Presidential Scholarship Gala
  • Athletics
  • Academic Support
  • General Scholarship
Academics Support Selection (Payroll Deducation):
Bi-Weekly Amount for Lion Fund Drive (Min. $5.00 per fund):
Bi-Weekly Amount for Presidential Scholarship Gala (Min. $5.00 per fund):
Bi-Weekly Amount for Athletics (Min. $5.00 per fund):
Bi-Weekly Amount for Academic Support (Min. $5.00 per fund):
Bi-Weekly Amount for General Scholarship (Min. $5.00 per fund):
Total Payroll Deducation Amount:
Please deduct money from my pay starting on/until.

DIRECT GIFT (CASH/CHECK/CREDIT CARD)

Please designate my gift(s) to the following fund(s): (Lion Fund (Annual Giving) Drive, Presidntial Gala, Athletics, Academics Support and/or General Scholarship)

  • Lion Fund Drive
  • Presidential Scholarship Gala
  • Athletics
  • Academic Support
  • General Scholarship
Academics Support Selection (Direct Gift):
Gift Amount (Lion Fund Drive)
Gift Amount (Presidential Scholarship Gala)
Gift Amount (Athletics)
Gift Amount (Academic Support)
Gift Amount (General Scholarship)
Total Gift Amount:

PLEDGE

Please designate my gift(s) to the following fund(s): (Lion Fund Drive and/or Presidential Gala).

  • Lion Fund Drive
  • Presidential Scholarship Gala
Pledge Amount (Lion Fund Drive)
Pledge Amount (Presidential Scholarship Gala)
Total Pledge Amount:
Total amount of the pledge:
I would like to be reminded of my pledge to be paid:

  • Monthly
  • Quarterly
  • Annually