Philanthropic Donation Report Form

Registered Campus Organization Information

Please provide the following informaiton about the Registered Campus Organization making the philanthropic donation.

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RCO Name: *

Full Name of Reporting Individual: *

Role in RCO: *

Please indicate whether you are a member, officer, committee member etc. If an officer or committee member, please indicate which position or committee.

UC Merced Email Address: *

Phone Number: *

Philanthropy Information

Please provide the following details regarding the philanthropy event, money raised and more.

Name of Philanthropy Event: *

Date of Event: *

Month

Day

Year

Time and Locaiton of Event: *

Please describe the event/initiative: *

Number of Participants: *

Total Amount Donated: * $

Benefiting Agency, Cause, or Person: *

Name of Contact for Donation Recipient:: *

Email Address of Contact for Donation Recipient: *

Phone Number of Contact for Donation Recipient: *

Confirmation and Verification

By Submitting this for, I verify all of the information above is true and correct.

Leave this field blank

Philanthropic Donation Report Form

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