Campus Recreation, Loyola University Chicago

Start Payroll Deduction

I hereby authorize Loyola University Chicago to deduct my Halas Sports Center Membership fee in proportionate amount of money from my paycheck each pay period.

The current rate of deduction is vaild for the current fiscal year and is based on the current annual membership rate. Deductions will continue until requested to stop.

NEW POLICY - PLEASE READ
Effective April 1, 2011, if the payroll deduction option is stopped before the ONE YEAR ANNIVERSARY of signing up, a $50 Early Stop Fee will be deducted, along with your final deduction.

You must be FULL TIME to be eligible for the Payroll Deduction option.
Deductions are based on 12 paychecks a year for Faculty and 26 paychecks a year for Staff.
Our system in unable to accomodate Part Time Faculty and Staff.

If you are creating a Family Membership, you will need to set up family members in person at the Halas Sports Center to get a Halas ID.

I understand the Halas Sports Center Membership fee will continue to be deducted until the stop deduction form is submitted.

Employee
First Name:

Last Name:

UVID:

Department:

Campus:

Home Phone:

Work Phone:

Effective Date:

Check the Appropriate Box	Payroll Schedule	Per Pay Period Deduction Amount	Number of Payments Annually
	Bi-weekly Individual	$12.47	26 Payments
	Bi-weekly Family	$23.62	26 Payments
	12 Months Individual	$27.00	12 Payments
	12 Months Family	$51.17	12 Payments
Classification: Faculty Staff

Campus Recreation|Loyola University Chicago

Campus Recreation

Start Payroll Deduction