Payroll Deduction Authorization

* First Name
* Last Name
* WWU Student ID Number
* I authorize Walla Walla University to deduct a percentage from my net wages (after taxes) to be applied to
my student account. Percent to be deducted:

I understand this authorization is voluntary, and may be cancelled at any time, or changed once per quarter
with at least one week's notice.

* By typing in your name and clicking on the "Submit" button below, you acknowledge your electronic signature and agree that all information you are providing to Walla Walla University on this application is true, complete and correct to the best of your knowledge.

    Mon May 30, 2016 7:02 pm
  * Response required