Special Education Foundation - SSD Payroll Deduction

Special School District payroll deduction form
for Special Education Foundation

SSD is offering payroll deduction as a way to donate to the Special Education Foundation.

Those wishing to contribute through payroll deduction have the option of doing so in one lump sum donation or distributing your donation of $50 or more over eight pay periods
(paychecks during October, November, December, and January).

Payroll deduction forms must be submitted by Sept. 25, 2025.

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Employee Number*

Employee Number

SSD Email

example@example.com

Home Phone Number

Please enter a valid phone number.

Building/Department (optional)

Number of Deductions*

One lump deductionDeducted over 8 pay periods

Total Amount:*

Electronic Signature*