To be submitted by the club advisor to the coordinator of student life and
copied to the advisor's academic dean.
1. Name of Group_______________________________________________________
2. Where do you wish to raise funds? (Check one)
___off campus only ___on campus only ___both on/off campus
3. If on campus where would the club like to conduct the fundraising?
*Please coordinate any table needs or items/locations needed for an activity or event with the
coordinator of student life, and the coordinator of campus development & events as needed.
4. On what date do you wish to begin_________, end_____________?
5. Please describe in detail the type of fund raising activities you wish to have.
What products or services will be sold? _______________________________________
Is this a raffle? ____________If so, how much will tickets cost? ____________________
(Please remember, per NCGS 14-309.15, only two raffles per club a year will be approved. No
less than 90% of the net proceeds of a raffle shall be used by the organization for charitable,
religious, educational, civic, or other nonprofit purposes. None of the proceeds may be used to
pay any person to conduct the raffle, or rent a building where tickets are received or sold.)
Will you be soliciting for donations? __________________________________________
If requesting donations, where? _______________________________________________
What is the fundraising goal amount to be raised?_________________________________
Other items for consideration _________________________________________________
6. In brief, why does your group need to raise funds at this time?
7. Please list any items/funds from other sources (such as in-kind gifts, monetary donations, etc.)
As a reminder, please copy your academic dean to this request for notification.
Club/organization advisors are encouraged to communicate their fundraising, events, and
activities with their dean prior to making an official request.
Name of Fund Raising Organizer
Ph #
Do Not Write Below This Line
_____Permission Granted
_____Permission Denied
Explanation: ____________________________________________________________
Signature of the Vice President of Student Services Date
Before submitting this form,please make sure you are following the guidelines set forth in policy and the
Student Organization Handbook.