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    governor6392
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    This form is for transmitting funds for an international Interact project, with three requested deadlines of January 7th, April 7th, and June 2nd to track fundraising progress. The form collects information about the Interact club submitting funds such as the amount, payment method, and contact details. It provides instructions to make checks payable to the District 5170 Foundation and include the memo for the 2011-12 Interact project, and to send funds before the end of the month to avoid check expiration.

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    This form is for transmitting funds for an international Interact project, with three requested deadlines of January 7th, April 7th, and June 2nd to track fundraising progress. The form collects information about the Interact club submitting funds such as the amount, payment method, and contact details. It provides instructions to make checks payable to the District 5170 Foundation and include the memo for the 2011-12 Interact project, and to send funds before the end of the month to avoid check expiration.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    11 views1 page

    Submission Form

    Uploaded by

    governor6392
    This form is for transmitting funds for an international Interact project, with three requested deadlines of January 7th, April 7th, and June 2nd to track fundraising progress. The form collects information about the Interact club submitting funds such as the amount, payment method, and contact details. It provides instructions to make checks payable to the District 5170 Foundation and include the memo for the 2011-12 Interact project, and to send funds before the end of the month to avoid check expiration.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    INTERNATIONAL PROJECT FUND TRANSMITTAL FORM

    Make checks payable to "District 5170 Foundation" with the Memo "Interact 2011-12."
    There are three requested deadlines to turn in funds so we may track fundraising
    progress against goals, but you may also send in money anytime. The three deadlines
    are January 7th, April 7th, and June 2nd.
    Interact Club ________________________________________________ Area #______
    Amount enclosed $ __________________________________________________
    Checks $ ___________________
    Cash $ ___________________
    Check #s ______________________________________________
    Club President __________________________________________________________
    Please print name legibly
    Direct phone number (______) _______-________________
    E-mail address __________________________________________________________
    Signature ____________________________________________ Date _____________
    Personal donations may be tax-deductible. Tax ID#: 94-3016176.
    Please send in all checks before the end of the month to avoid check expiration.
    Mail all funds with this form to ensure credit to your Club and Area.
    For questions, call the number below, or e-mail:
    Christine Kyauk
    District Council Secretary
    secretary@interact5170.org

    Office Use Only


    Account #:
    Date Mailed:

    Interact 5170
    a Rotary International
    sponsored youth
    organization

    96 N. Third Street
    Suite 150
    San Jose, CA 95112

    PHONE
    FAX
    E-MAIL
    WEB SITE

    (408) 280-7587
    (408) 882-0373
    rotary@interact5170.org
    www.interact5170.org

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