Request to Create Account

     

     

    Name of Organization: __________________________________  Date: ______________________

     

    Type of Account:

    _____  Student

    _____  Faculty/Staff

     

    Source of Funds:          Type of Expenditures:

    _____ Fundraisers          _____  Services

    _____  Dues            _____  Supplies

    _____  Donations          _____  Travel

    _____  Other: ___________________________  _____  Other: _____________________________

     

    Please provide the name and operator number for processing requisitions (if applicable):

     

     Enter requisitions:  ___________________________

     Approve requisitions:  ___________________________

     

     

    The Controller’s Office will deposit and disburse funds in accordance with established policies and procedures of Delgado Community College. The Controller’s Office will return any request for funds in excess of available balances.

     

    ______________________________________________________________________________________

    Signature of club/group representative      Print Name      Title with club/group

     

    ______________________________________________________________________________________

    Signature of faculty/staff advisor (if applicable)  Print Name      Title

     

     

    APPROVALS:

    For Student Accounts:

     

    __________________________________________________________ ______________

    Campus Chief Student Life Officer Date

     

    __________________________________________________________ ______________

    Campus Chief Student Affairs Officer Date

     

    __________________________________________________________ ______________

    Campus Provost/Dean Date

     

    For Faculty/Staff Accounts:

     

    __________________________________________________________ ______________

    Appropriate Campus Provost or Vice Chancellor Date

     

     

    ______________________________________________________________ _____________

    Controller Date  

     

    Controller’s Office use only:   Date received:

    Acct. # assigned: Date completed:

    Form No. 3300/001 (6/00)

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