Voluntary Deduction Dollar Amount per Payroll Period/Semi-Monthly: *
I hereby authorize the Alexandria City Public Schools payroll office to deduct from my salary the amount indicated below and designate these funds to the Scholarship Fund of Alexandria. I understand that the entire amount of my payroll deduction will support the General Fund of the Scholarship Fund that awards financial need-based scholarships to academically qualified, ACPS graduates to pursue higher education. The deduction will be effective for each payroll period following receipt of this authorization and will continue until further notice from me. A tax receipt will be issued annually.