Committee For Good Schools PAYROLL DEDUCTION FORM

Contributions will be sued to help support current and future levy campaigns. Deductions will begin with the first pay of the month following your sign-up date, and will be on a continuing basis. You may discontinue your participation at any time.

Name Name First Last
Buildling
New Contributor

New Contributor $1.00 $2.00 $3.00 $4.00 $5.00 $6.00 $8.00 $10.00 Other Amount Other Amount
Current Contributor

Current Contributor I am a current contributer I'd like to increase my contribution by :
Signature (by typing my name, represents my electronic signature
Date Date / MM / DD YYYY