New Endowment Account Form

Team Information:
Team Name (as it will be listed on our website): 
Team Address: 
Do You Have a Separate Shooting Team Checking Account? 
Yes No
Attach W-9: 
W-9 Entity Name: 
What type of non-profit is your W-9 entity? 
Active Shooting Team Disciplines (check all that apply):
Air Rifle Air Pistol Smallbore Shotgun Blackpowder
How many active members are on the team? 
Contact Information  (One contact should be a board member)
Primary Contact Name: 
Relationship to Team: 
Primary Contact Address: 
Primary Contact Phone: 

Secondary Contact Name: 
Relationship to Team: 
Secondary Contact Address: 
Additional Information:
Team Website and/or Facebook Page: (if applicable) 
Referred by: (list team or group) 

  By signing below, I confirm the following:
1. All information submitted is correct to the best of my knowledge.
2. My team is in compliance with the four team requirements listed on the MidwayUSA Foundation website http://midwayusafoundation.org/start-your-account.
3. All endowed funds are the sole property of the MidwayUSA Foundation and grants from my team's account are not guaranteed.
Please Sign Your Name Above With a Mouse or Stylus

If you are having problems submitting the form above, click here to download the PDF version.