The correct form will have at the top “Higher Education Authorization Form” and have “Houston 33” in the top left corner. You can obtain the form in one of the following ways:
- by contacting your department or college SECC coordinator
- by calling the Office of Community Relations and Institutional Access at 832-842-5090
- by requesting a form online
Instructions for filling out the four parts of the form are on the back of the form.
- Provide identification information requested.
- Indicate how you want to be acknowledged and give your home address.
- Explain how your gift should be distributed.
- Select recipients for your gift from the eligible charitable organizations listed in the 2016 Mini Directory and the Complete 2016 Directory of Charities
- Each charitable organization has a SIX DIGIT CHARITY CODE: the first two digits correspond to its charitable group. There are 19 charitable group codes. If you are giving to several organizations please note that you can only select organizations within three charitable groups.
- Fill in the SIX DIGIT CHARITY CODE for each charitable organization you want to receive a gift and the gift amount. There is a minimum donation of $2 per charitable organization.
- Select a payment option: One-time gift OR monthly payroll deductions. Cash will not be accepted this year. There is no online giving.
One-time gift by check or money order
- A completed pledge form must accompany each check or money order. Fill in all appropriate blanks, including the institution’s name (University of Houston).
- Make your check or money order payable to: “State Employee Charitable Campaign”
- Do not provide your social security number; instead provide your MyUH (PeopleSoft) ID.
- A completed pledge form is required.
- Specify on the pledge form the Total Monthly Gift, the number of Pay Periods Per Year (9 or 12) and the Total Annual Gift.
- Deductions will take effect on paychecks paid out January 2017.
- Biweekly employees will have deductions taken from the first paycheck of the month. Faculty on 9-month assignments can select payroll deductions for 9 months.
- All other employees will have 12 monthly deductions.
- There is no one-time payroll deduction.
- The UH/SECC deduction will be the last deduction taken prior to any direct deposit of pay.
- Authorize the payroll deduction by signing your name above “Employee Signature”.
Keep the pink copy of the completed pledge form.
Return the white and yellow copies of your completed pledge form (with check or money order if appropriate) in one of the following ways:
- Turn in your department or college SECC coordinator or
- Deliver to Room 223 Ezekiel W. Cullen Bldg. or
- send by campus mail to:
University of Houston
Office of Community Relations and Institutional Access
Ezekiel W. Cullen Building
4302 University Drive Room 212
Houston, Texas 77204-2018
Location: Room 223
Attn: Elwyn C. Lee