Request to Hold a Fundraising Event
Name of Organization:
Does the Organization have an Agreement with the University?
Details of fundraising event to include what, when, where, and how, as well as intended use of the
funds (attach additional sheet(s) as needed):
Attach any proposed annoucements or advertisements.
Announcements must contain a statement the event was approved by the USU President.
Space reserved
with MDL?
Is food involved? If yes, how will the food be prepared?
If food is involved, coordination with the cafeteria is required.
Cafeteria Manager/Representative Signature:
If preparing food on the USU Campus, coordination nation with the
cafeteria is required.
USU Office of Environmental Health and Safety Representative
Signature:
Reque
stor’s Sign
ature/Title/Date:
Requestor
’s
Contact Information
:
Organizations composed primarily of military
members and/or spouses must attach Br
igade coordination.
Review by Office of General Counsel (A1030):
I h
ave reviewed this request and determined that the activity is permissible under DoD Directive 5500.7-
R, 3-210, para. a (6), which allows the agency head to approve fund-raising by “[o]rganizations composed
primarily of DoD employees or their dependents when fundraising among their own members for the
benefit of welfare funds for their own members or their dependents when approved by the head of the
DoD Component command or organization after consultation with the DAEO or designee. (This includes
most morale, welfare and recreation programs, regardless of funding sources)”.
Ethics Official
Signature and Date:
Approved / Disapproved
Richard W. Thomas, MD, DDS, FACS
President, USUHS
Rev: 3/23/17
