Club Deposit Form
Date: ____________________________________
Campus Life Personal: _________________________
Telephone Ext: __________ Email: ____________
Club Name: ____________________________ Club Account #: ______________________
Name of Depositor: _______________________ Club Position: _______________________
Email of Depositor: __________________________________________________________
Signature: _________________________________________________________________
Description of Fundraising Event:_________________________________________________
________________________________________________________________________
Form of Payment : Check Cash
Checks
Check Number Amount
__________ ____________
__________ ____________
__________ ____________
__________ ____________
__________ ____________
__________ ____________
__________ ____________
__________ ____________
Total: ____________
For Office Use Only: Signature/Stamp form the Bursar’s Office
Cash
_____ X $.01 = ________ _____ X $1.00= ________
_____ X $.05 = ________ _____ X $5.00= ________
_____ X $.10 = ________ _____ X $10.00= _______
_____ X $.25 = ________ _____ X $20.00= _______
Total: _______ _____ X $50.00= _______
_____ X $100.00= ______
Total: _____________
________ + ________ = ___________
Checks Cash Total Deposit
