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Contact Information
Pledge Information

Monthly Amount

Monthly Amount X 12 Months = Total Pledge Amount

Amount to be deducted from October paycheck only

**You will be redirected to the donation page after you submit this form where you will enter your credit card information**

Address Information:

Designation Information: All pledges become part of the LISD Employee Giving Fund unless otherwise stated in this box.
NOTE: Half of each non designated payroll deduction received this school year will be awarded to your campus at the beginning of the next school year.

Signature:

*Upon termination of employment, I authorize any unpaid balance to be deducted from my final payroll check.

Does your spouse's employer offer a matching gift program? If so, please list the name of the employer.

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