AVON OLD FARMS SCHOOL
PAYROLL AUTHORIZATION FORM
ANNUAL GIVING
I authorize Avon Old Farms School to deduct $____________ from my weekly/monthly
pay for Annual Giving. This withholding will begin on ____________, 200__ and will
continue each month or week until I notify the Business Office, in writing, to either stop
or change my contribution.
_______________________________
Signature
______________________________
Today’s Date
_______________________________
Print Name
Please distribution the annual giving to the following accounts:
Please keep a copy of this form for your records