Upstate Foundation Forms

Frequently used Upstate Foundation forms in a fillable format. 

Donation related forms 

Community Events donation form 

Donation form used for fundraising events held throughout the community to raise money for Upstate Foundation funds. 

Donation form

Donation form used for general donations to the Upstate University Hospital. 

Friend in Deed donation form

Donation form used for the Friend in Deed Annual Fund for Upstate University Hospital. 

Gift-in-Kind donation form - Golisano's Children Hospital

Donation form used to document non-monetary donations designated for the Golisano's Children Hospital. 

Gift-in-Kind donation form - Upstate Foundation

Donation form used to document non-monetary donations to the Upstate Foundation. 

Planned giving notification of estate gift intention

This form is to be used to document any intention by donors to include The Upstate Foundation in their estate. 

Pledge sheet form

Form used to make a pledge to the Upstate Foundation. 

Pledge sheet form with named giving option

Form used to make a named gift pledge to the Upstate Foundation.

 

New fund related agreements and forms

Donor advised fund agreement form

This is the agreement required to be filled out when a donor chooses to open a new donor advised fund with the Upstate Foundation. 

Donor advised fund distribution request

Use this form to submit any distribution requests to qualified charitable organizations from your fund. 

Endowment agreement form

This is the agreement required to be filled out when a new endowment is created with the Upstate Foundation. 

New fund form

This form is used to request the creation of a new fund. 

 

Purchase order related forms

Purchase order form

This form used to request purchases and general disbursements by Upstate Foundation Fund Advisors. 

Single sole source form

This form is to be submitted with any purchase requistion that exceeds an aggregate value of $20,000 where competitive bids have not been solicited (or are not available). 

Travel reimbursement form

This form is used to request payment for expenses related to travel by Upstate Foundation Fund Advisors. 

Vendor solicitation form

This form is used to document the vendor selection process when competitive bids have ben solicited. 

 

Upstate Medical University policies

Access to Donors/Coordination Policy

Standard/purpose: To provide for coordinated and efficient fundraising requests.