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Donations – Valley View I.S.D. E-Pledge Card
Region One ESC Employee Pledge Form
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
*
Monthly/Mensual
Semi-Monthly/Semi-Mensual
Email/Correo Electrónico
*
Address/Residencia
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
I authorize Region One ESC Payroll Department to process the pledge information entered above for payroll deduction beginning January 2022 through August 2022.
*
Agree
