Please submit a completed copy of this form to the Office of the Dean of the Faculty
(jeanb@southwestern.edu) for the purchase of awards/gifts associated with department/program
achievement awards and honors. These purchases should be funded through the Student Award/Gift
Account and should not be in the form of cash or cash equivalents, such as gift cards. The tangible
property awarded should be valued at no more than $75.00 per award. (Note: Awards funded
through an account dedicated for a specific achievement award should follow the M.O.U./guidelines
set forth when the fund was established.)
Student Recipient's Name:
Student ID Number:
Name of Award:
Department/Program Presenting Award:
Date of Award Presentation:
Value of tangible property awarded:
Description of item(s) awarded (e.g., plaque, book):
Prepared By:
Date:
Account #:
(Use 11-3065-54555 if charging to the Student Award/Gift account administered by the DOF. Otherwise, include the
appropriate account number and name of the account established specifically for this award. Please make purchases
with your corporate card and use the account number entered above when coding this charge into SmartData.)
Has the student submitted a completed W-9 to you (or previously to the Business Office)?
YES / NO
DOF Approval:
Date:
Southwestern University
Student Award/Gift Form (non-scholarship)
