Columbia Cycling Club

Application for Contribution Toward Benefit Ride

Based on the decision of the Board of Directors of the Columbia Cycling Club on November 6, 2000, a donation is available to members seeking donations for Benefit Rides in which they are intending to be a participant. The donations are available under following conditions:

1) The bicycle ride must be a Benefit Ride. A ride is considered a Benefit Ride when the participant is expected to raise funds from other people in excess of $99, the profits of which are for a non-profit cause, often a cure for a disease. The official application of a Benefit Ride contains language specifying a "minimum pledge." This is to be distinguished from a simple entry fee for a cycling event that may be in excess of $99 due to the event's extensive nature, the likes of which is not provided for by this Application.

2) The participant must have been a member of the Columbia Cycling Club for at least one year from the time of request for a donation.

3) The participant must be a resident of Maury County or one of its adjacent counties.

4) The member must have assisted the Club at some time in the following ways:

a) Volunteered at one of the Columbia Cycling Club sponsored races or tour.
b) Held an office with the Columbia Cycling Club
c) Participated in a significant roll on a committee or the Club's newsletter
d) Worked on the trails at the Chickasaw Trace Park on a designated work day or a specific project recognized by the Club.

The Board has approved donations for qualifying individuals as follows:

1) Where the minimum donation level to enter an event is $100-$149, the donation from the Club shall be $35. 2) Where the minimum donation level to enter an event is $150 or more, the donation from the Club shall be $50.

I respectfully request $_______ to be contributed on my behalf towards the following:

Name of event______________________________________ Date of event________________

Check should be written to:_______________________________ (the check must be written to the non-profit organization fund and not an individual)

I attest that the aforementioned event and my involvement in the Club qualify under the above provisions.

Signed____________________________________

Print name_________________________________

Send completed application to:
Treasurer
Columbia Cycling Club
1116 W. 7th St., PMB 127
Columbia, TN  38401

Approved by______________________

Paid (date) _________________

Check # _______________