Chapter Charity Account Application

Chapter Charity Account Application

Chapter Name*

Chapter #*

Chapter Charity Account Representative (CCAR)*

CCAR Full Address (include city, state and zip)*

CCAR email*

CCAR Phone*

Project Category*

Select

Project description, preservation or almoner name*

Date of Event/Presentation (if you have one)

Amount of request*

Check made payable to (recipient name)*

Recipient address*

Recipient City*

Recipient State*

Recipient Zip*

Minutes from business meeting approving the withdrawal*

Drag and drop files here or

Date Submitted*

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