Fundraiser Student Fee Applica1on Request

Submit to the Treasurer only when student has unresolved outstanding money due. A8ach previously signed Fundraiser Student Sales Acknowledgement form.

Fundraiser Sponsor/Advisor Contact Name: ____________________________________________________

Fundraiser Descrip?on: ____________________________________________________________________________

Amount outstanding: $________________________________

Money Recipient is: □200-______; □300-________; or □Support Organiza?on Name ________________________

Upon payment of fees, money will be moved to above recipient.

Treasurer’s Oﬃce Use only

Date of fee payment ___________________

Amount deposited $___________________

Treasurer to no=fy Sponsor/Advisor Contact listed above when payment is made.

Rev 0 March 2024