1. Request to Create Account

BA-6313.1 --------------------, 2007
 




Request to Create Account
 

Name of Organization/Entity: _____________________________  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 Executive Dean Date
 
For Faculty/Staff Accounts:
 
__________________________________________________________ ______________
Appropriate Campus Executive Dean Date
 
______________________________________________________________ _____________
Controller Date  

 
Controller’s Office use only:   Date received:
Acct. # assigned: Date completed:

                                                                                                                           
Form 3330/001 (6/12)

Copy: Office of Institutional Advancement

 

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