DOS Charitable Contributions Form

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Charitable Contributions Required Approvals

To be attached to expense report

Benefiting Non-Profit Organization: ___________________________________________________________

Contribution Amount: $___________

Description of the Contribution: ______________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Name of Department/Student Organization: ______________________________________________________

COA String and POET Information: ___________________________________________________________

_______________________________________________________________________________________

Requested By: ________________________________________________________                  Date: _________

Requester email address: _____________________________________________________________________
(Requester to forward form to Student Org advisor for approvals)

Advisor Approval: _______________________________________________________               Date: __________

Dean Approval: _________________________________________________________              Date: __________

Provost (or designee) Approval: ____________________________________________              Date: __________
(Donations over $1,000)