ABATE of MN Gambling Request Form

A.B.A.T.E. of Minnesota

Chapter Gambling Account

Request Form

This application must be submitted 1 week before the monthly gambling committee meeting.

                                    Mail to:           Kim Ostlund 

                                                            P.O. Box 382

                                                            Faribault, MN 55021

 

Chapter Applying:______________________________ Date of App._______________

 

Dollar amount requesting:________________________ Date Needed:_____________

 

Date Chapter approved the use of the money:_________________________________

**A Copy of the minutes from that meeting must accompany this request.

 

Explain Below what the money is needed for and please include instructions where to send donation:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Chapter Authorization:______________________      ___________________________

                                                Chapter President                                  Chapter Treasurer

 

OFFICE USE ONLY

 

Date Received:___________________ Date Next Gambling Meeting:______________

 

Chapter Account Balance:_____________ Minutes Current:                        YES                NO

 

Date Approved:__________________ Authorized Signature:_____________________

                                                                                                                        Gambling Manager