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
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.