Humble ISD Education Foundation Employee Payroll Deduction

FOUNDATION PAYROLL DEDUCTION FORM

Complete the form below to enroll in ongoing gift to the Education Foundation through payroll deducation.

District Email Address *

Employee Number (MUNIS) *

Last Name *

First Name *

Home Address (for tax receipt) *

City *

State *

Zip Code *

Your Home Campus / Building *

Department (if you are not on a campus)

Amount per paycheck (must be at least $1) If you would like to review the giving level incentives, please click here. *

$3/pay period - "The Final Countdown"

$5/pay period - "Don't Stop Believing"

$12/pay period - "Nothing's Gonna Stop Us Now"

$20/pay period - "I'm Still Standing"

$25/pay period - "We Built This City"

Other Amount/pay period (must be at least $1.00) Other Amount/pay period (must be at least $1.00)

I consent to my name being listed in the donor list on the Education Foundation's website. *

Yes, I would like for my name to be listed.

No, I do not wish to be listed.

Promotional items are offered as a thank you to donors and an opportunity to market the Foundation on your campus. However, you may opt out of promotional items and in return, school supplies will be donated to a student in need. *

Pledges of $5 or more per pay period will receive a campaign t-shirt (if you elected to receive the promotional items). Please list your t-shirt size below.

Years worked in Humble ISD *

How did you hear about the campaign and what made you decide to make or change your gift today?

If you are an Humble ISD graduate, please share with us the high school and graduation year.

Please include below any comments you would like to share with Dr. Fagen and the Foundation Board: