Common Form - The University of Texas at El Paso

Alumni Perks
Get Involved
Students
Events
Stay Connected
Awards
Give to UTEP

Payroll Deduction Form

Personal Information

First Name is RequiredFirst Name*

Last name requiredLast Name*

RequiredAddress *

City requiredCity*

State requiredState*

Zip code requiredZip Code*

UTEP email requiredPlease enter a valid email address with the format youraddress@yourdomain.Campus Email*

Required fieldPlease enter a valid email address with the format youraddress@yourdomain.Personal Email*

RequiredSpouse Name*

Campus Address

Campus Address/Building requiredCampus Address/Building*

Department requiredCampus Department*

RequiredCampus Phone Number*

RequiredPlease select all that apply

Faculty

Staff

Alum

Gift Options

RequiredI would like to make a monthly payroll deducted gift until I cancel.

Yes

Required I would like to make a monthly payroll deducted gift for the next number of months.*

Required$100*

Required$50*

Required$25*

Required$15*

Required$10*

RequiredOther*

Direct my monthly gift to

Please pick one of the following area designations:*

RequiredCollege Selection*

RequiredDepartment*

RequiredOther*

Authorization for Payroll Deduction

By checking this box, I authorize this deduction from my after-tax wage for a charitable contribution as indicated. I understand that deductions will begin with the next available pay period following this submission, and that deductions will continue until my employment with UTEP ends or until the time period I selected expires or until I cancel by contacting the UTEP Institutional Advancement Office, Kelly Hall 6th Floor in person or by phone at (915) 747-8533. *

RequiredI agree*

Enter your 10 digit UTEP Employee ID No. (i.e. 600xxxxxxx) Enter UTEP Employee ID 600# *

Click to view help for this field.You can retrieve your Employee ID number by logging into PeopleSoft - https://my.shared.utsystem.edu

RequiredDate*

RequiredElectronic Signature (Type name)*

Scroll to Top

Make a Gift
Miner Athletic Club
UTEP.edu

Stay Connected

facebook
twitter
youtube