Care to Wear Registration Form

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The intent of "Care to Wear" is to provide continuous support for the Health, Hunger and Hygiene needs of LR students. Faculty and Staff are allowed to wear blue jeans on specified days in support of the LR Care to Learn Program. Please complete the below form if you wish to participate in Care to Wear. This automated payroll deduction will assist many school personnel by eliminating the need to handle and account for money. For confidentiality, administrators will be able to view a list of personnel signed up for "Care to Wear" for their respective school, but the amount of your contribution will only be seen by the payroll department. Thank you for your commitment to LR kids.

First Name

Last Name

Email address

Location

District Offices

High School

Middle School

Upper Elementary

Elementary

Primary

Transportation

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Amount to be deducted per pay period:

$10

$20

Other:

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This will be a monthly payroll deduction until the payroll department has been notified of your desire to cancel. Please allow one months notice to cancel the automated deduction. Do you agree with these terms?

Yes

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Submit

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