Donations – Edcouch-Elsa I.S.D. E-Pledge Card

Name/Nombre*

First Middle Last

Campus/Dept./Departamento*

Complete Employee ID #/Número Completo de Empleado*

Last four of your SS#/Últimos 4 números del Seguro Social*

Donation Amount Per Pay Period/Cantidad de Donacion por Periodo de Pago.*

Pay Period Frequency/Frecuencia de Periodo de Pago*

Semi-Monthly/Semi Mensual

Email/Correo Electrónico*

Address/Residencia

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

I authorize my School District Payroll Department to process the pledge information entered above for payroll deduction. Yo autorizo a el Departamento de Nómina del Distrito Escolar a procesar la información de compromiso para la deducción de nómina.*

Agree

I authorize my School District Payroll Department to process this pledge as recurring, beginning in the Fall of 2020. I will contact my district's Payroll Department to make changes. Yo autorizo al Departamento de Nómina del Distrito Escolar para el cual trabajo, a procesar esta promesa como recurrente a partir de otoño de 2020. Me pondré en contacto con el Departamento de Nómina para realizar cualquier cambio.*

Agree

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Donations – Edcouch-Elsa I.S.D. E-Pledge Card

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