Yes! I am making an impact at
Mississippi State every day!
First Name___________________________________
Last Name___________________________________
Address______________________________________
Address______________________________________
City_________________________________________
State, ZIP____________________________________
Phone_______________________________________
MSU E-mail___________________________________
Staff/Faculty ID________________________________
Signature_________________________ Date__/__/__
I want to support Mississippi State University
through Campus Payroll Deduction with a total
gift of:
$1,000
$500
$250
$100
Other: $_________
Payment will be deducted each pay period until the total
amount specified above has been reached. An MSU payroll
deduction pledge can be cancelled with a 30-day notice.
Please designate my gift and amount(s) to:
ND:
AMOUNT:
Mississippi State Fund (100010)
College of _______________________
MSU-Meridian (310706)
Staff Council Fund (310659)
Faculty Achievement Awards (400579)
Zacharias Staff Recognition Fund (500852)
Other:___________________________
$_______
$_______
$_______
$_______
$_______
$_______
$_______
You may find additional giving options and make
online gift payments at msufoundation .com. All
gifts are tax deductible.
Please return this form
with payment to the MSU
Foundation, P.O. Box 6149,
Mississippi State, MS, 39762.
DMFS