Revised 8/2017
To: Lisa Bevis (824-2105)
Office of Development
Shelbie King Hall 316
(1)
Date:
Campus address:
Suggested organization name:
(or Existing Org Name & #)
Describe purpose of organization:
Authorized Approvals:
Print name
(This area used only by UAH Foundation Accounting & Reporting)
_____________________________________________________ _________________________________________________________
Approved Date
______________________________________________________ __________________________________________________________
Organization Number Organization Name
Prepared by: Originating department:
REQUEST FOR NEW ORGANIZATION
or
CHANGE NAME and/or SIGNATORIES
Signature
(2)
Print name
Signature
Approved:
Budget Unit Head - Print Name
Budget Unit Head - Signature