become a 30/60/90 employee
Becoming a 30, 60, or 90 minute employee is easy -- just fill out this form. If you choose to participate, the equivalent of 30, 60 or 90 minutes of pay will be deducted from each pay period for one year. Feel free to contact us with any questions you may have. If you'd rather give a one-time donation, please visit our Give Online page.

EMPLOYEE INFORMATION:

name:

e-mail address:

UNID #

department:



home address:

city, state:

zip:

phone:
Deduct the following plan from my paychecks:
90 MINUTES pay for each pay period for 1 year
60 MINUTES pay for each pay period for 1 year
30 MINUTES pay for each pay period for 1 year

OR...
I would like choose my own donation amount*:
$ per check for periods.
*Amounts less than the equivalent of 30 minutes will not be recognized on the Employee Donor Wall for the expansion.