Deposit Transmittal Form
Date Received
Donor Name Account # Account Name Amount
*All deposits containing cash must be hand-delivered to the Foundation Office. (201 Community College Drive, Governor's Bldg., 2nd Floor, Baton Rouge, Louisiana 70806)
Total Deposit:
**All checks should be made payable to Baton Rouge Community College Foundation.
If special handling is required, check below.
Matching gift form attached
Special acknowledgement request (acknowledge: )
Memorial/"in honor of" notification required (notify: )
Pledge Payment
New address for donor(s) (new address: ____________________________________________)
Other: ______________________________________________________________________
Submitted by: __________________________________________________ _____________________________
(Name and Title) Phone Number
__________________________________________________ ______________________________
(Signature) Email Address
Theryl Drew/Exec. Asst. to VC Smith
225-216-8040
drewt@mybrcc.edu
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Deposit Transmittal Form