Clubs and Organizations Student Handbook

Appendix 6: Waiver

Appendix 7: Deposit Form

Faculty Student Association DEPOSIT FORM

WAIVER

The Class of

Council of the SUNY College of Optometry will not

From: To: Erin Angarola, College Bursar

allow anyone under 21 years of age to attend or be served alcohol at the (name of event)

Date:

Please deposit the following into the Faculty Student Association bank account, as indicated below:

on

Sub-Total Cash $

Sub-Total Checks $

$

Total Deposit for:

I,

,the Class of

President,

(Name of Program, Fundraiser, Professional Society, etc.)

state that anyone who attempts to come to this event and is underage will be asked to leave, and will not be served alcohol.

Source of funds (please check one) Contributions (5810)

Membership dues (5850)

Cap & Gown (5880)

Date:

Program Fees (5820)

Fundraising (5860)

Yearbook (5890)

Organization (please check one) Class of

Graduate Class (FGRA)

SOAPP (FPPC)

AOSA (FAOS)

Gold Key (FGOL)

Student Council (FSTU)

APHA (FAPH)

CCOSA - Chinese (FCCO)

SVOSH (FSVO)

BSK (FBSK)

NJSOA - (FNJS)

EyeBall (FEYE)

COSA - California (FCOS)

CTSAO - Connecticut (FCTS)

NORA (FNOR)

COVD (FCOV)

Lion's Club (FLEO)

CLEAR (FLCA)

CSA / CAOS - Canadian (FCSA)

NOSA (FNOS)

Vision Walk (FWLK)

Residency (FRES)

NYSOA (FNYS)

ACE (FACE)

FCO (FFCO)

SAAO (FSAA)

Other

Dr. Guilherme Albieri Vice President for Student Affairs OR Vito Cavallaro, AVP for Student Affairs Authorized Signature of Organization/Class Officer

Date:

Date:

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