**NOTE: All Information is Required
Your Name First Name Last Name Duke Unique ID Telephone Number Email Address Re-Type Email Address Total amount for Spring 2010 term to be deducted: $ (minimum $250) Note: Total amount will be equally dividend over deductions. Spring 2009 deductions will be taken in January, February, March and April if your request is received by December 20, 2009 Requests received between December 21, 2009 and January 25,2009 will have deductions taken in February, March and April. Deduction requests for spring term will not be accepted after January 25. Pay Date(s): Select From Below Monthly (on the 25th) Monthly (on the last day of the month) Bi-Weekly Additional Information or Comments: Please type this verification code in to the below box: 13672
Total amount for Spring 2010 term to be deducted: $ (minimum $250)
Note: Total amount will be equally dividend over deductions. Spring 2009 deductions will be taken in January, February, March and April if your request is received by December 20, 2009 Requests received between December 21, 2009 and January 25,2009 will have deductions taken in February, March and April. Deduction requests for spring term will not be accepted after January 25.
Pay Date(s): Select From Below Monthly (on the 25th) Monthly (on the last day of the month) Bi-Weekly
Additional Information or Comments:
TERMS & CONDITIONS By submitting this form I authorize the Bursar's Office to make payroll deductions for the total amount and time period shown on the form above. I have read and agree to abide by the terms and conditions. Enrollment is subject to approval by the Bursar's Office.
By submitting this form I authorize the Bursar's Office to make payroll deductions for the total amount and time period shown on the form above. I have read and agree to abide by the terms and conditions. Enrollment is subject to approval by the Bursar's Office.