For Bishop's Faculty & Staff

For Bishop's Faculty & Staff
Name*

PrefixFirst NameLast Name
Employee Number
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Bishop's Email*
Example: yourname@ubishops.ca
Please select between a one-time donation or a repeated donation below and enter the desired amount in one of these two options.
Repeated donations:
I authorize the following amount to be deducted from EACH PAY for 26 pay periods (starting November 16, 2025, ending November 14, 2026)

$5$10$15$20$25$50Other
One-time donation:
I authorize the following amount to be deducted only ONCE from my pay:

$5$10$15$20$25$50Other
This form is protected against SPAM*
Should be Empty:

Repeated donations: