Today's Date : October 13, 2019 
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New Gift Fund Request Form

Form Completion Instructions
  1. Please complete every field on the New Gift Fund Request Form before submitting it.
  2. Please send all original gift paperwork along with a copy of the new designation request form to the Gift Services Deposit Box at 10889 Wilshire Blvd. Suite 1000, Mail Code 160348. For Gift Transmittals and Gift Submission instructions please click here (https://island.fim.ucla.edu/eabusiness/giftadmin/).
    *Please note that Fund Management cannot establish your new fund until a copy of the New Designation Request Form and corresponding gift paperwork has been received by Gift Processing.
  3. If the fund is being established for a solicitation please send a copy of the solicitation remit or link to the online giving site to AskFundManagement@support.ucla.edu.
Preparer

Date that the form is being submitted:
First Name:
Last Name:
Email Address:
Phone:

Gift Fund Information

Entity:
Expense Account:
Cost Center:
Fund Director/Principal Investigator:

Choose School and Department:
Fund Name:

Fund Type:

Fund Purpose Category:
Student Support Type (for student support funds only):
Fund Purpose Description:
Name of Authorized UCLA Support Group (if applicable):

Initial Gift Information
Donor Name (if applicable):
Gift amount (if applicable):
Payment Type (if applicable):
 
Check here if fund is being established for solicitation/on-line giving

Check here if the fund is being established with a pledge

Check here if the fund is being established with a straight gift
 
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