Survey - Annual Employee Payroll Deduction Pledge Form - SYF Means Graduation. No Matter What. Now More Than Ever.

Annual Employee Payroll Deduction Pledge Form

Other Amount

Field Is Required Number of pay periods - payments will be distributed over number of pay periods selected. For example if your pledge is $130 and you select 26 pay periods, your bi-weekly deduction will be $5.00.

You may choose to automatically renew your gift each year for as long as you are employed by Simon! By selecting this option, you will not be required to complete a new donation form during future campaigns, and your payroll deduction will cease if you are no longer employed by Simon and bear you no future encumbrance. You may always discontinue your payroll deduction at any time by contacting SYF.

Yes, I would like to automatically renew my gift each year and agree to have my payroll deductions continue until I am no longer employed by Simon.
No, please set up my payroll deduction for one year only, and send me new forms for future campaigns.

If yes, please select one of the following options for payroll deductions in future years:

Each year, increase my gift by 10%.
Each year, increase my gift by 5%.
Each year, increase my gift by 3%.
I would like my gift to remain the same each year.

Or, each year increase my gift by (OTHER) $

Your Information

Title

Field Is Required First

Field Is Required Last

Field Is Required Street 1:

Field Is Required City/Town:

Field Is Required State / Province:

Field Is Required ZIP / Postal Code:

Field Is Required Country:

Field Is Required Email:

If you respond and have not already registered, you will receive periodic updates and communications from syf.org.

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Field Is Required Nickname

Field Is Required Simon employee ID number

Field Is Required Simon Employee Location

I would like more information about volunteer opportunities.