Payroll Deduction Form

Kettering Education Foundation
Supporting Excellence in Education

To make a one time donation
with Paypal click here.

or continue below

Donor Information (please print or type)
*required field

Name:*

Address 1:*

Address 2:

City:*

State:*

Zip Code:*

Telephone (home):

Last 4 digits of Social Security Number
(required for payroll deduction)*

Email:

Pledge Information

My gift is enclosed in the amount of

$

I would like to enroll in the automatic payroll deduction please deduct

$ from each of my bi-weekly paychecks for the next year.

I (we) wish to have our gift remain anonymous.

Yes

Signature(s)*

Please return this completed form by interoffice mail to the Board of Education Building on or before September 26 , 2008.
The first pay for payroll deduction will be October 11, 2008.

Thanks for helping us achieve 100% district participation!

NOTE: After completing the form, please print a copy for your records by clicking the print button below. After printing, click submit to email the form to Kettering Education Foundation.