Employee Contribution Form

Page 1


Name:

St. Pius X Employee Contribution Form

Payment options:

Option 1: PAYROLL DEDUCTION

❒ I would like St Pius X to deduct $ from each paycheck beginning (date) for (purpose) (area of greatest need, alumni brick, or specific program)

Option 2: CREDIT CARD

❒ Please charge $ to my credit card (Circle One) Visa / MasterCard I American Express for (purpose) (area of greatest need, alumni brick, or specific program)

Card #

Sec Code

Exp Date

Billing Zip Code

You may also make your gift online at wwwsaintpiusx com/give

Option 3: CASH/CHECK

Enclosed is my gift of $ for (purpose) . (area of greatest need, alumni brick, or specific program)

How would you like to be listed in our publication of donors?

❒ I would like my gift to be anonymous

I would like to make my gift ❒ in honor of or ❒ in memory of:

Employee Signature: Date:

Please return this form to Erica Peña (in the Administration Building) or scan and email erica pena@spxabq org

Thank you for your support of the Annual Fund!

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