Purchasing Power Payroll Deduction/Eligibility Form

In order to be financially responsible, the following information must be initially collected for a one time qualification process with Purchasing Power. Your information will not be used for any other purpose. All information collected here is collected in a secure and and encrypted environment.

In order to be fully enrolled in Payroll Deduction, please complete the Payroll Deduction Authorization form, which can be found directly below. Once completed, including a signature, please upload it at the bottom of the page before submitting the online form.