JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
WCPSS Payroll Deduction Pledge Form 24-25
Please answer the following about payroll deduction pledge. Payments will be deducted monthly based on the amount selected below.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
WCPSS Email Address
*
Your answer
WCPSS Id Number
*
Your answer
Please list the full name of your school
*
Your answer
Your Street Address, City, State, Zip
*
Your answer
Your Phone Number
*
Your answer
Please choose how much you would like to pledge for payroll deductions.
*
$45.00 / month to celebrate 45 years of Artists in Schools!
$30.00 / month
$25.00 / month
$20.00 / month
$15.00 / month
$10.00 / month
$5.00 / month
$3.75 / month (a total annual donation of $45.00 to celebrate 45 years of Artists in Schools!)
Other:
Required
Do you authorize a monthly payroll deduction of the amount specified above to support the work of the United Arts Council of Raleigh and Wake County?
*
Yes
Required
Thanks to our campaign sponsors!
LM Restaurants
Goldfish Swim School
Videri Chocolate Factory
Larry's Coffee
Rocky Mountain Chocolate Factory
Shake Shack
Watered Garden Florist
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of United Arts Council of Raleigh and Wake County.
Does this form look suspicious?
Report
Forms
