Thank you for your interest in establishing a Donor Advised Fund at The University of Alabama and for providing the information below. After completing this form, please return it to the Office of University Advancement in the enclosed envelope.
Application Donor/Founder Information
Today’s date________________
Donor/Founder 1 Dr./Mr./Mrs./Ms.___________________________________________________________________ SS # _______________________________ Address ___________________________________________________________________________ City/State/Zip _____________________________________________________________________ Phone: Business ( ____ ) _____________________ Home ( ____ ) _________________________ E-mail address (optional) __________________________ Date of birth (optional) ___/___/____ Donor/Founder 2 Dr./Mr./Mrs./Ms.___________________________________________________________________ SS # _________________________________ Address __________________________________________________________________________ City/State/Zip _____________________________________________________________________ Phone: Business ( _____ ) ____________________ Home ( _____ ) ________________________ E-mail address (optional) _________________________ Date of birth (optional) ____/____/____
Fund Name Proposed name of the fund: _____________________________________________________________________________Fund The University of Alabama Donor Advised Fund lists names of funds in its Annual Report unless otherwise indicated. Do you want your fund in the Donor Advised Fund Annual Report? (Please check one.) ❑ Yes, I would be pleased to have my fund listed in Donor Advised Fund publications. ❑ No, I prefer to be anonymous.
Advisors to the Fund Please list the initial advisor(s) to the fund (if different than founder(s)). Note: All advisors serving at a given time must sign grant recommendations from the fund. Dr./Mr./Mrs./Ms.____________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone: Business ( ___ ) _______________________ Home ( ___ ) _________________________ E-mail address (optional)____________________ Relationship to Founder(s)________________ Dr./Mr./Mrs./Ms.____________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone: Business ( ___ ) _______________________ Home ( ___ ) _________________________ E-mail address (optional)____________________ Relationship to Founder(s)________________
Successor Advisors If any, please name the successor advisors to your fund. Advisors may represent two generations of a family (usually, the founder and the founder’s children).The minimum age for an advisor is 21. Successor advisors to serve (check one): ❑ concurrently ❑ consecutively (if consecutively, list below in order of succession) Dr./Mr./Mrs./Ms.____________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone: Business ( ___ ) _______________________ Home ( ___ ) _________________________ E-mail address (optional)____________________ Relationship to Founder(s)________________ Dr./Mr./Mrs./Ms.____________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone: Business ( ___ ) _______________________ Home ( ___ ) _________________________ E-mail address (optional)____________________ Relationship to Founder(s)________________
Recommended Investment Strategy Please indicate which investment pool you recommend for your fund (choose only one). ❑ Money Market ❑ Conservative ❑ Balanced ❑ Growth ❑ Equity Index Please sign and date: ____________________________________ Founder 1 ____________________________________ Date
_______________________________________ Founder 2 ________________________________________ Date
Optional Information In order to serve you better, we request that you provide us with the following optional information. Areas of General Charitable Interest What types of charities do you generally support (check all that apply)? ❑ Arts ❑ Environment ❑ Education ❑ Human Services ❑ Religious Organizations ❑ Other (please name)________________ ❑ I have no specific area of interest __________________________________ Colleges/Programs of University Interest What areas of The University of Alabama are you interested in supporting (check all that apply)? ❑ School of Law ❑ College of Arts and Sciences ❑ Culverhouse College of Commerce and ❑ National Alumni Association ❑ Capstone College of Nursing Business Administration ❑ School of Social Work ❑ College of Communication and ❑ Division of Student Affairs Information Sciences ❑ College of Community Health Sciences ❑ University Athletics ❑ University Honors Programs ❑ College of Continuing Studies ❑ University Libraries ❑ College of Education ❑ University Museums ❑ College of Engineering ❑ College of Human and Environmental ❑ Other (please name)________________ ❑ General use Sciences Areas of interest within the College/Programs ❑ Scholarships ❑ Unrestricted
❑ Faculty support ❑ Facilities/maintenance
Referral Information How did you hear about The University of Alabama Donor Advised Fund program? ❑ Attorney ❑ Advertisement ❑ Accountant ❑ University of Alabama Web site ❑ Financial Advisor ❑ Other ____________________________ ❑ Friend or family member _________________________________
Professional Advisors To assist us in addressing any questions that may arise, please provide the name and contact information for your professional advisor(s) with whom you authorize us to discuss this matter.
Attorney: Dr./Mr./Mrs./Ms. ___________________________________________________________________ Firm ______________________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone ( ___ ) ______________ Fax ( ___ ) ______________ E-mail_________________________
Accountant: Dr./Mr./Mrs./Ms. ___________________________________________________________________ Firm ______________________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone ( ___ ) ______________ Fax ( ___ ) ______________ E-mail_________________________
Other Advisor (i.e., financial planner, insurance agent, investment broker) Dr./Mr./Mrs./Ms. ___________________________________________________________________ Firm ______________________________________________________________________________ Address ___________________________________________________________________________ City/State/Zip ______________________________________________________________________ Phone ( ___ ) ______________ Fax ( ___ ) ______________ E-mail_________________________ Thank you. We look forward to working with you.
Donor Advised Fund Box 870122 Tuscaloosa, AL 35487 (205) 348-4767 or (888) 875-4438 Fax: (205) 348-8871 www.daf.ua.edu