Support Ukraine

Payroll Deduction Donations to Support Ukraine

Complete the below online form to authorize payroll deduction(s). All deductions will be given to Ukrainian Federal Credit Union, who will deliver 100% of donations to Ukraine.

If you prefer to provide cash donation, please bring donation to Human Resources on 8 Memorial.

Your name, Employee number, and contact information provided below will not be shared. It is requested for the purpose of processing the payroll deduction and in case Crouse Payroll needs to reach you about a problem with your form (ex: if you make an error in listing your employee number).

Question Title

* 1. First and Last Name

Question Title

* 2. Crouse Employee ID (as listed on your badge)

Question Title

* 3. Email Address (will not be shared externally)

Question Title

* 4. Cell Phone Number (will not be shared externally)

Question Title

* 5. Donation Amount

$20 (deducted from single paycheck)

$40 (will be divided evenly over 2 paychecks)

$60 (will be divided evenly over 2 paychecks)

$80 (will be divided evenly over 2 paychecks)

$100 (will be divided evenly over 2 paychecks)

Other Amount (donations exceeding $20 will be divided evenly over 2 paychecks)

Question Title

* 6. Initial below to authorize payroll deduction for the amount you indicated above. I agree that in the event of separation from employment, I am legally obligated to satisfy the balance immediately through payroll deduction or direct payment to my employer.