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Benevolent Fund Enrollment Form

Please Fill Out The Benevolent Fund Enrollment Form Below

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Pampa ISD Benevolent Fund Program

Pampa ISD offers a Benevolent Fund Program on a voluntary basis for all Pampa ISD employees and their spouses. No dues or fees will be collected unless a death occurs among the membership. Death benefits will be paid directly to the beneficiary of a deceased member within two or three working days. The amount paid will be based upon the number of active participants at the time of the death multiplied by $10. Each participant will then reimburse the school district $10 through payroll deduction the month following the occurrence of a death. If a spouse is also a participant, $20 will be deducted. There are no administrative costs. Please examine the following statements and sign and date your selection. This record will be retained in the Business Office and serves as a basis for administering the program. Elections can be changed or dropped during open enrollment.



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Acceptance and Digital Signature

By clicking the submit button below, I am providing my electronic signature which Indicates my receipt, understanding, and agreement to the above terms. I understand and agree that my electronic signature carries the same force and effect as my handwritten signature.



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Pampa Independent School District is an Equal Opportunity Employer


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