Foundation for Vancouver Public Schools VPS Staff Payroll Pledge Form

The following form is intended for use by employees of Vancouver Public Schools. All other donors should use our general Donation Form. Thank you.

VPS Staff Campaign Payroll/Pledge Form

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Account ID
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Contact ID
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Opportunity Amount
Name*
First Last
VPS Employee #*
Primary Building Assignment*
Additional Building Assignment
Billing Address*
Street Address City State / Province / Region ZIP / Postal Code
Work Email*
Personal Email
Preferred Phone*
Phone Type*
- Mobile
- Home
- Work
Method of donation*
- Payroll Deduction
- I will mail a check
- Contact me about making a donation through stock, donor advised fund, or other method
Payroll Deduction Frequency*
- Payroll/Single Deduction
- Payroll/Monthly Deduction
Deduction will begin with your 1/2023 paycheck.
Donation Amount:*
For monthly donations, enter the amount to be withdrawn per paycheck.
- $100.00
- $75.00
- $50.00
- $25.00
Will your gift be matched by your spouse/partner’s employer? List the company name:
Consent*
I hereby authorize Vancouver Public Schools to deduct the amount(s) entered from my paycheck. I understand I may cancel my donation via payroll deduction by submitting a written request to the VPS payroll department.
I authorize my donation.
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Email
This field is for validation purposes and should be left unchanged.

Δ

360.313.4730

foundationvanps@vansd.org

2901 Falk Rd Vancouver WA 98661

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The Foundation for VPS has been granted non-profit status under Section 501(c)3 of the Internal Revenue Service Code. Federal ID #91-0971800.