Request Donation Template

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					Club Lego Example
Club Lego, Founded and recognized in June 2000, is on a mission to promote Legos and its positive effects on
children and adults world wide. Officers are elected every April and events/fundraisers are held monthly. The
club has 25 members and dues are $10 per person.

Here is a rundown on the events and activities on the club as of October 1, 2001
On August 27th, the club had a car wash at the Port Republic Exxon where they rented three hoses for $15 and
bought soap and a bucket for $10. The weather was nice and so were the patrons, they donated $105 total for
the afternoon.

The club had a candy sale for the week o f September 10-15 where they purchased 10 bo xes of Royal Brick
Chocolate Bar with M int Inside for $5/box. Each bo x had 23 bars, sold for $1 each. Every bar was sold, giv ing
the club $230 of revenue

Todd Leh man, owner/ad ministrator of the Lego Users Group Network (LUGNET) decides to donate $125 to
the club because he wants to see more Adult Fans of Lego (AFOL)s come out of our college campuses.

On the 23rd of September, Legos and Activism took place in order to heighten the awareness of the need of
Legos for kids in the third-world countries. Faculty for Camp Anawana joined the cause and bought two
buckets of Lego for $20 to match Club Lego's contribution of two Lego buckets. Each bucket has 1200 bricks
and each brick is sold for $.05. Each brick was sold, a nice large lego house was built, donated to the
Massanutten Library for display, and the profits were donated to the National Movement of Legos for the Poor.

Here is the dilemma for Club Lego:
A conference has been called by the Lego Group of A merica to discuss the future of Lego bricks in
Philadelphia after a magazine article in Fast Co mpany.co m Magazine called the toy " unadaptable" and
"doomed for the 21st Century." Club Lego has been invited to join since they are a premiere club of AFOLs.
They will take a van for eight over and stay at the President's mama's house overnight. This is important to the
student body, since lots of kids secretly play with Legos and build great creations instead of doing destructive
like drinking or COB 300

So here is the simulat ion!
positive effects on
eld monthly. The


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 hoses for $15 and
ted $105 total for


of Royal Brick
bar was sold, giv ing


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e campuses.

s of the need of
d bought two
et has 1200 bricks
ted to the
Legos for the Poor.



ricks in
ptable" and
e club of AFOLs.
 is important to the
 doing destructive
Directions for Contingency Request V1.2:
Thank you for using the SGA to help your organization put on an event. This template is designed to help
decern your treasury in the format the finance committee wishes to have for review. It also filters out
anything that can not be requested from the SGA as stated in its by-laws. Follow these directions
to help make your request for the Contingency Account:

1) Do not touch any of the colored blocks
2) Put your yearly activity in the "Club Activity Sheet"
3) Your request needs to be itemized, place your event budget in the request form on the third sheet
4) You should retitle any of the fundraiser names, non-profit events, revenues and expenses to be more specific
5) Notes on Fundraisers, events, and club activities can be made on the fifth sheet

Questions or comments? Call Chris Fortier at (540)568-6376

First, answer these questions
1) When was the organization recognized by JMU?                            Jun-00
2) What is your organization tax ID number?                                 3489213740
3) What is your organizational mailing address?                       Box 7777 JMU
e more specific
Club Activites Sheet

Last Year's Balance    $       65.00

Membership Dues                         Club Dues to pay                    Donations to Club
# of members                       25   State Chapter       $         -     From Todd Lehman    $   125.00
Dues                   $       10.00    National Chapter    $         -     Donation #2         $      -
Membership Total       $      250.00    Int'l Chapter       $         -     Donation #3         $      -
                                        Club Dues Total     $         -     Donation #4         $      -
                                                                            Donation #5         $      -
                                                                            Donation #6         $      -
                                                                            Donations Total     $   125.00

Fundraising
Car Wash                   8/27/2001    Candy Sale              9/15/2001   Fundraiser 3 Name 1/0/1900
Sales                  $      105.00    Sales               $      230.00   Sales               $      -
Purchases              $       10.00    Purchases           $       50.00   Purchases           $      -
Rentals                $       15.00    Rentals             $         -     Rentals             $      -
Profit/loss            $       80.00    Profit/loss         $      180.00   Profit/loss         $      -


Fundraiser 4 Name ate
                D                       Fundraiser 5 Name
                                                       Date                 Fundraiser 6 NameDate
Sales                  $         -      Sales               $         -     Sales               $      -
Purchases              $         -      Purchases           $         -     Purchases           $      -
Rentals                $         -      Rentals             $         -     Rentals             $      -
Profit/loss            $         -      Profit/loss         $         -     Profit/loss         $      -


Events
Legos and Activism9/23/2001             Event 2 Name            1/0/1900    Event 3 Name        Date
Anawana Contribution   $       40.00    Co-Sponsorships     $        -      Co-Sponsorships     $      -
Expected Sales         $      240.00    Expected Sales      $        -      Expected Sales      $      -
Total Revenues         $      280.00    Total Revenues      $         -     Total Revenues      $      -
Food                   $         -      Food                $        -      Food                $      -
Room Rental            $         -      Room Rental         $        -      Room Rental         $      -
Supplies               $       40.00    Supplies            $        -      Supplies            $      -
Speaker/Performer      $         -      Speaker/Performer   $        -      Speaker/Performer   $      -
Publicity              $       15.00    Publicity           $        -      Publicity           $      -
Honorariums            $         -      Honorariums         $        -      Honorariums         $      -
Total Expenses         $       55.00    Total Expenses      $         -     Total Expenses      $      -


Event 4 Name           Date             Event 5 Name        Date            Event 6 Name        Date
Co-Sponsorships        $         -      Co-Sponsorships     $         -     Co-Sponsorships     $      -
Expected Sales         $         -      Expected Sales      $         -     Expected Sales      $      -
Total Revenues         $         -      Total Revenues      $         -     Total Revenues      $      -
Food                   $         -      Food                $         -     Food                $      -
Room Rental            $         -      Room Rental         $         -     Room Rental         $      -
Supplies               $         -      Supplies            $         -     Supplies            $      -
Speaker/Performer      $         -      Speaker/Performer   $         -     Speaker/Performer   $      -
Publicity              $         -      Publicity           $         -     Publicity           $      -
Honorariums            $         -      Honorariums         $         -     Honorariums         $      -
Total Expenses         $         -      Total Expenses      $         -     Total Expenses      $      -


Donations to Charity
To Legos for the Poor $       225.00    To Charity #3       $        -      To Charity #5       $      -
To Charity #2         $          -      To Charity #4       $        -      To Charity #6       $      -
Financing Summary
Last Year's Balance   $   65.00

Yearly Revenues                    Yearly Expenses
Membership Dues       $   250.00   Club Dues            $      -
Donations (total)     $   125.00   Club Donations       $   225.00
Car Wash              $   105.00   Car Wash             $    25.00
Candy Sale            $   230.00   Candy Sale           $    50.00
Fundraiser 3 Name     $      -     Fundraiser 3 Name    $      -
Fundraiser 4 Name     $      -     Fundraiser 4 Name    $      -
Fundraiser 5 Name     $      -     Fundraiser 5 Name    $      -
Fundraiser 6 Name     $      -     Fundraiser 6 Name    $      -
Legos and Activism    $   280.00   Legos and Activism   $    55.00
Event 2 Name          $      -     Event 2 Name         $      -
Event 3 Name          $      -     Event 3 Name         $      -
Event 4 Name          $      -     Event 4 Name         $      -
Event 5 Name          $      -     Event 5 Name         $      -
Event 6 Name          $      -     Event 6 Name         $      -
Total Revenues        $   990.00   Total Expenses       $   355.00
Treasury Amount       $   700.00
Contingency Request
If a convention                        If purchasing equipment            If holding event
Number of People                   8   Purchase Price       $       -     Co-Sponsorships        $   -
JMU Van Rental        $     245.00     Accessory #1         $       -     Expected Sales         $   -
Gas Expenses          $       50.00    Accessory #2         $       -     Food                   $   -
Parking               $       25.00    Accessory #3         $       -     Room Rental            $   -
(Write in expense per person)          Total Purchase Fund $        -     Supplies               $   -
Air/Train/Bus Fare    $         -      Eligible for request $       -     Speaker/Performer      $   -
Food Expenses         $         -                                         Spe./Perf. Travel      $   -
Hotel Expenses        $         -                                         Spe./Perf. Hotel       $   -
Registration          $       70.00                                       Publicity              $   -
Funds Ineligible      $     600.00                                        Honorariums            $   -
Total Travel Fund     $     880.00                                        Funds Ineligible       $   -
Eligible for request  $     280.00                                        Total Event Fund       $   -
                                                                          Eligible for request   $   -
                                       Total Orange Blocks   $   880.00
                                       Less Treasury         $   700.00
                                       Total Need            $   180.00
                                       Total Eligible Need   $   280.00
                                       Your Request          $   180.00
Notes
Fundraiser #1




Fundraiser #2




Fundraiser #3




Fundraiser #4




Fundraiser #5




Fundraiser #6



Event #1



Event #2



Event #3



Event #4



Event #5
Event #6



Request notes

				
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