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Workplace Giving form
Support UniSA’s Fight Against Cancer Fund through Payroll Deductions
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My details
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Required
Employee ID
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Family Name
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Given Names
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School/Unit
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Please enter a valid email address with the format youraddress@yourdomain.
Email address
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My contact details
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Home Address Line 1
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Home Address Line 2
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Suburb
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State
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Postcode
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Mobile Number
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Work Number
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I request that the following Workplace Giving arrangements be implemented from the next available pay.
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Type of gift:
Fortnightly recurring gift
One-time gift
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Please deduct the following amount from my pay each fortnight
$10.00
$25.00
$50.00
$100.00
Enter your own value
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This field is required.
This value is not unique.
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Until I advise otherwise or until (date)
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Or to the amount of
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Please deduct from my salary a one-off amount of
$50.00
$100.00
$250.00
$500.00
Enter your own value
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This field is required.
This value is not unique.
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