Employee Payroll Deduction Form

Thank You!

As a member of the Columbus State family, your support is particularly meaningful. We at the Foundation continue to be inspired by the selfless generosity of Columbus State employees.

Title*

First Name*

Last Name*

Cougar ID*

Phone*

Email*

Street Address Line 1*

Street Address Line 2

City*

State*

Zip*

Please direct my gift to:

First-Generation Scholarship Fund

Area of Greatest Need

Other

If Other please specify:

Payroll Deduction:

I would like to increase my current contribution from each of my paychecks to (dollar amount):

I authorize Columbus State to deduct from each of my paychecks (dollar amount):

Columbus State Foundation
550 East Spring Street
PO Box 1609
Columbus, Ohio 43216-1609
P: 614-287-2436 | F: 614-287-5476

Full Site