MCPSEF Account MOU Request

Requestor

MCPS Educational Foundation is asked to open an operating account by:

Date of Request

mm/dd/yyyy

Account Name

The name of the account should match what the account will be publicly referred as

Account Description

What is the purpose of this account fund? What program, services, and expenses will the account cover?

Account Point of Contact Name

The following person(s) will receive account reports and have primary disbursement authority (i.e. has to approve release/use of funds from the account)

Account Point of Contact Mailing Address

Account Point of Contact Email

Account Point of Contact Phone Number

Phone

Additional disbursement authority?

Yes

Unknown

Disbursement Authority #1 Email

Disbursement Authority #1 Phone Number

Phone

Disbursement Authority #2 Name

Disbursement Authority #2 Email

Disbursement Authority #2 Phone Number

Phone

Initial Gift (if applicable)

(Optional) Anticipated Donors

Special Instructions

If generally unrestricted, write "Unrestricted" in text field.

Send me a copy of my responses

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