Financial Responsibility Form - Special Olympics Minnesota
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1Financial Responsibility Form
Team Name: ___________________________________________________
Team Code: __________________
Team Manager: ____________________________________________________________________________________
Last
First
Middle Initial
Finance Chair: ______________________________________________________________________________________
Last
First
Middle Initial
Finance Chair Mailing Address: ________________________________________________________________________
Number
Street
Apt. #
__________________________________________________________________________________________________
City
State
Zip Code
Work Phone: (
) ______________________
Home Phone: (
) _____________________
Email Address: _____________________________________________________________________________________
Areas/Delegations fall under one of the two categories below. Please check the one that applies to your situation:
_______ 1. The Delegation raises and expends funds under the name of Special Olympics. The Delegation Finance Chair
will comply with the Centralized Accounting policies as determined necessary by the State Office. All monies raised and
expended in the name of Special Olympics will be documented according to accounting policies and procedures set by the
State Office.
_______ 2. Three-year renewal noting that you have read and understand the Finance Guide.
The agreement has been fully explained to me, and I have read the provision set forth by Special Olympics Minnesota. I
fully understand these provisions and will comply with each in the name of the Area/Delegation.
______________________________________________________________________________________________
Team Finance Chair Name (print)
___________________________________________________________
___________________________
Team Finance Chair Signature
Date
______________________________________________________________________________________________
Head of Delegation Name (print)
___________________________________________________________
___________________________
Head of Delegation Signature
Date
This form must be filled out and sent to the State Office whenever there is a change in Finance Chair and must be approved by the Head of Delegation.
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Parent category: Financial