ANNUAL RENEWAL TO OPERATE A PARENT ORGANIZATION OR BOOSTER CLUB

Superintendent Robert R. Bravo, Ed.D. Board of Trustees: Stacey Brown Matthew T. Dean Wendy Dillingham Kalen Gallagher Linda Goytia Campbell Union High School District Branham High School Del Mar High School Leigh High School Prospect High School Westmont High School Boynton High School CACE: Campbell Adult/Community Education ANNUAL RENEWAL TO OPERATE A PARENT ORGANIZATION OR BOOSTER CLUB Campbell Union High School District (CUHSD) would like to thank all the parent organizations or booster clubs for their continued support. Attached is the information on how to file and/or update your club s application with the school district per Board Policy 1230. Information regarding this process is outlined in the District s Guidelines for Parent Organizations and Booster Clubs (GPOBC) manual. Requests for authorization and/or reauthorization are subject to board approval annually upon receipt of the documents. We appreciate you taking the time to fill them all out. All CUHSD parent organizations and booster clubs must comply with all of the following rules annually or their authorization to operate can be revoked: 1. Submit Request for Authorization to Operate - Renewal (see forms p. 1-3) 2. Renewal applications received by May and approved by the governing board authorize the organization to operate in the subsequent school year. a. If the renewal application is not submitted by May, the organization may not operate until specific district authorization is received. 3. Submit any changes to the evidence of California state and federal 501(c)(3) tax-exempt status (see Intro 2) 4. Submit any changes to Employer Identification Number (EIN) a. Parent organizations and booster clubs are responsible for maintaining their own taxexempt status, accounting, financial records and income tax reporting to both the federal and state government. (see Intro 2) 5. Submit any changes to California Secretary of State approved Statement of Information, Articles of Incorporation and Bylaws (see Intro 2) 6. Submit an annually signed CUHSD Parent Organization or Booster Club Operating Manual Acknowledgment form (see forms p. 4) a. The CUHSD Parent Organization and Booster Club Operating Manual must be adopted and approved by the organization s governing board and a copy of the meeting minutes where approval occurred submitted to the district business office. 7. Submit an annual Certificate of Liability from their insurance company. Liability insurance in an amount equal to or exceeding the minimum coverage amounts determined by the district. Intro 1 of 2

8. Submit an annual signed Hold Harmless Agreement (see forms p. 5) 9. Submit a current member roster of names and a contact list of officers complete with addresses, phone numbers and Email addresses. (see forms p. 6) 10. Must submit complete, up-to-date financial statements (Balance Sheet and Income Statement) to the school site principal and the CUHSD business office twice each year. The two financial report submissions should represent July 1 st December 31 st and January 1 st June 30 th. They should be submitted no later than 30 days after the end of the reporting period (January 30 and July 30 of each fiscal year). a. All financial statements submissions must contain up-to-date information on the parent organization s or booster club s revenue and expenses as well as the net gain or loss for each fundraiser held. Before submission, the financial statements should be reviewed and signed by the organization s treasurer. 11. Submit a copy of their non-profit federal and state tax return forms 990, 199, and, if applicable, Registry of Charitable Trusts form RRF-1. These federal and state forms should be submitted to the district business office no later than 30 days from the date of filing. 12. Submit a copy of the bank account statement and list of authorized signers (see forms p. 7-8) 13. Submit a proposed budget and list of proposed fundraising activities at the beginning of each school year in order for a determination to be made that there are no fundraising conflicts with other school activities, such as ASB. (see sample p. 9) a. All fundraising activities at any CUHSD school site are directly under the control of school site authorities and must be approved in advance per the governing s board Facility Use Policy. (see forms* p. 10-11) 14. All officers must attend the district s Annual Parent Organization and Booster Club Workshop. *Additional Forms: Fundraising Forms (see forms p. 10-11) Donation Forms (see forms p. 12) Fundraising & Donation Forms can be found at the Booster Link at CUHSD Intro 2 of 2

I certify that copies of all of the following documents required by the district are attached to this request: (Please check all boxes.) Constitution Bylaws Proof of Tax ID # California s Seller s permit 501(c)(3) Federal Determination Letter Proof of State Tax Exempt Status Hold Harmless Agreement Certificate of Liability Insurance Insurance Endorsement Page Proposed Budget List of Proposed Fundraisers Manual Acknowledgement Form Certification of Attendance at Annual Parent Organization/Booster Workshop NOTE: Any information or required documents missing from this request will prevent a parent organization or booster club from being approved by the CUHSD Board of Education. The financial records of any parent organization or booster club operated under district board policy are subject to audit at any time either by district personnel or by an accounting firm designated by the superintendent. All announcements of events and related parent/guardian permission slips shall clearly indicate that the activity or event is sponsored by the parent organization or booster club and not by the school site or district. All parent organization or booster club requests for use of CUHSD school facilities must be filed with the CUHSD Facilities/Planning Department. Prior to conducting any fundraiser, the parent organization or booster club must obtain written approval by the district s business office and the Board of Education. CUHSD administrative regulations require that all transportation arrangements involving district students must be made through the district s transportation department. Goods or services are NOT to be ordered in the name of the school or school personnel. Opportunity drawings are regulated by California Penal Code section 319-329. Parent organizations/booster clubs are responsible for completing all of the California Attorney General s annual raffle registration and reporting requirements for raffles or opportunity drawings BEFORE holding an opportunity drawing or raffle. On behalf of the officers and members of the Parent Organization or Booster Club, I have read this form and hereby agree to abide by its terms. This authorization when granted will be valid until May of the following school year; however, we understand that if the superintendent or designee considers it necessary, this authorization to operate can be revoked at any time. Signature of Parent Organization/Booster Club President School Principal Activities Director Page 2 of 12

Campbell Union High School District Board of Education Recognition and Authorization to Operate for school year: 20-20 of the Parent Organization/ Booster Club. Campbell Union High School District Board of Education By: By: President Assistant Secretary Page 3 of 12

Superintendent Robert R. Bravo, Ed.D. Board of Trustees: Stacey Brown Matthew T. Dean Wendy Dillingham Kalen Gallagher Linda Goytia Campbell Union High School District Branham High School Del Mar High School Leigh High School Prospect High School Westmont High School Boynton High School CACE: Campbell Adult/Community Education Parent Organization or Booster Club Board Policy/Administrative Regulation And Parent Organization or Booster Club Operating Manual Acknowledgement Form As an elected officer of the Parent Organization or Booster Club operating within the Campbell Union High School District, I hereby certify that I have received copies of and have read Campbell Union High School District Board Policy 1230(a) School Connected Organizations, Administrative Regulation 1230(a), District Board Policy 1321(a) Solicitation of Funds From and By Students, Administrative Regulation 1321(a), and the CUHSD Parent Organization or Booster Club Operating Manual. I understand the procedures outlined in the board policies, administrative regulations and parent organization or booster club manuals control the operations of our organization and will adhere to them. At any time should I have questions regarding policies or procedures, I will contact the school site administration for clarification or further instruction. I further understand it is the responsibility of the parent organization or booster club to fully understand and obey all California laws that govern the operation of parent organizations/booster clubs. Whenever necessary, our parent organization or booster club will seek competent professional financial and tax advice for accounting and filing requirements. I understand and agree that the Campbell Union High School District assumes no accountability or liability for the actions of or the operation and management of any parent organization or booster club. I also understand that as an officer of the parent organization or booster club, and member of the executive board, I am required to ensure the parent organization s or booster club s procedures and operating practices are financially and legally sound and in conformance with Campbell Union High School District board policies and all rules, regulations, laws, ordinances and statutes applicable to the organization. I further understand and accept that I am legally obligated to be prudent and reasonable in conducting myself to help preserve and protect the district and the Parent Organization or Booster Club. Signature: : Printed Name: Phone/Cell #: Address: Email: Parent Organization/Booster Club Name: Office Held: Page 4 of 12

Superintendent Robert R. Bravo, Ed.D. Board of Trustees: Stacey Brown Matthew T. Dean Wendy Dillingham Kalen Gallagher Linda Goytia Campbell Union High School District Branham High School Del Mar High School Leigh High School Prospect High School Westmont High School Boynton High School CACE: Campbell Adult/Community Education HOLD HARMLESS AGREEMENT The Parent Organization or Booster Club and its officers or operators hereby agree to indemnify, defend, and hold harmless the Campbell Union High School District, its board members, officers, agents, teachers, staff or any other employees from any damage, injury or harm involving any student, parent or third party arising from or which occurs in any way as a result of or related to parent organization or booster club activity regardless of location, including every claim or demand made, every liability, loss, damage, or expense of any nature, whatsoever, by any student, parent or third party which may be incurred by reason of: Death or bodily injury to persons, loss of or injury to property, or any loss, damage or expense which may have been sustained by the parent organization or booster club or its representatives or participants, including any corporations, district employees, firms or corporations employed by the parent organization or booster club which arises from negligence or misconduct on the part of the parent organization or booster club, its representatives, students or participants, or which in any way is related to parent organization or booster club activity, regardless of date, time or location. Any injury to or death of persons or damage to property, any loss or theft sustained by persons, firms or corporations, including the applicant participating in parent organization or booster club activity or conduct related to parent organization or booster club activity, or otherwise arising from any act of neglect, default, omission, negligence or willful misconduct of the applicant, its members, or any person, firm or corporation employed by the applicant, either directly or by independent contract, and attributable in connection with the activity covered by this agreement, on or off district property and during or outside of school hours. The Parent Organization or Booster Club, at its own expense, cost and risk, shall defend any and all actions, suits or other proceedings that may be brought or instituted against the district, its board, officers, agents, or employees and shall pay or satisfy any such claim, demand, liability or judgment rendered against the district, its board, officers, agents, or employees in any action, suit or other proceedings arising out of the parent/booster activities. ACKNOWLEDGED AND AGREED BY PARENT (print name) ORGANIZATION OR BOOSTER CLUB PRESIDENT: Signature: : Printed Name: Page 5 of 12

Under CUHSD Board Policy: All funds collected from fundraisers must be deposited into the parent organization/booster club bank account. All expenses must be paid by check from the parent organization/booster club bank account. Proper receipts and invoices must be maintained for all disbursements. Checks must never be made payable to the order of Cash. I hereby certify that the listed bank information is accurate and complete with respect to Parent Organization or Booster Club. I understand that our parent organization s or booster club s financial statements must be submitted to the school principal and to the district business office each January 30 nd and June 30 st of each school year. Signature Title Name (Please Print) Address Phone/Cell No. Email Page 8 of 12

CUHSD Booster 2014-2015 Budget Vs. Actual CUHSD Budget Vs. Actual: US Bank Account Starting Balance (carry over 2013-14) 7/1/2014 2014-2015 Income Actual Revenue Donations $ 2,638.00 Tickets Sales $ 13,270.00 Fundraisers: Restaurant of the month Panda Express $ 128.00 Pizza My Heart $ 99.00 Buffalo Wild Wings $ 65.51 Le Boulanger $ 47.00 Fish Six Restaurant Group $ 51.96 Rubio's $ 119.00 Other Fundraisers: Flocking Orders $ 465.00 Goodwill $ 991.99 See's $ 308.00 Fiesta $ 742.00 Tuxedo- $10 per order $ 110.00 Now and Forever $ 250.00 Other Income: PTSA Scholarship $ 400.00 TOTAL: Actual/Proposed Income $ 19,685.46 Carry Over Balance $ 8,301.23 Total Available: $ 27,986.69............, ;.:. c;i,(i 1 ;\ ): J/i:.; )" ' y. :.;<1'.... ' <.ii.... Activities Entertainment $ 1,549.00 Games $ 488.00 Goody Bags $ 1,077.41 Souvenirs-Blankets $ 1,175.75 Transportation: Transportation (3 buses+ Tip) $ 2,955.00 Venue Venue $ 10,750.00 Activities $ 1,016.00 Decorations $ 150.80 Other Expense: Previous Year Exp & PTSA reimbursement $ 2,847.81 TOTAL: $ 22,009.77 Carry Forward Balance $ 5,976.92 9,301.23 2014-2015 Budget $ 2,638.00 $ 13,270.00 $ 128.00 $ 99.00 $ 65.51 $ 47.00 $ 51.96 $ 119.00 $ 465.00 $ 991.99 $ 308.00 $ 742.00 $ 110.00 $ 250.00 $ 500.00 SAMPLE $ 19,785.46 $ 8,301.23 $ 27,086.69,... <, < -.. r $ 1,649.00 $ 488.00 $ 1,077.41 $ 1,362.67 $ 2,955.00 $ 10,750.00 $ 1,016.00 $ 150.80 $ 2,847.81 $ 22,296.69 $ 5,790.00 US Bank Account Page 9 of 12

Fundraising Request Form, page 1 CUHSD Fundraising Request Form This form must be filled out for each fundraising event that is planned during the year. School: submitted: Requesting organization: Person in charge: s of proposed activity: Location of proposed activity: Approximate number of students involved: Approximate number of supervisors provided: Nature of activity: (i.e., candy sale, book fair, etc.): Purpose of activity: (How will the instructional program for all students be enhanced or the attitudes of students, parents, staff, and community be promoted?) Budget Plan: See reverse No alcohol will be sold or consumed at this event(s). Approved by: President Student Representative- ASB Principal District Office use only Please submit entire form to Business Office. Approval form will be returned to school. Approved by Director of Financial Services Governing Board Vicenti, Lloyd & Stutzman LLP Page 10 of 12

CUHSD Fundraising Request Form, page 2 Budget Plan: 1. Complete and attach a Revenue Potential Form. 2. Specify how funds are to be solicited: 3. Will a cash box be required? Yes No 4. Specify forecasted income: 5. Specify forecasted expenditures: 6. Specify forecasted net profit: 7. % of profit donated to ASB: 8. % of profit donated to school: 9. % of profit donated to District: Items 7, 8, and 9 must add up to 100%. 10. If % of profit donated to ASB is greater than 0, specify accounts in ASB to receive donations, and specify percentages to each ASB account from existing Chart of ASB Accounts: ASB Account # % of profit donated to ASB 11. After proceeds have been generated, complete a Donation to ASB Form and attach a copy. Vicenti, Lloyd & Stutzman LLP Page 11 of 12

Donation to ASB, School, or District Form Donation to ASB, School, or District Name of Donor: Street Address: City, State, & ZIP: Telephone: Description of the donation: (If cash or check, show the exact amount; if other than cash or check, include a detailed description of each item, including serial number, color, etc.) Donor s estimate of value: Purpose of the donation (ASB organization, school site, or district program): If the donation is for a club or organization that is part of a school s ASB, indicate the name of the club or organization and deposit the cash or check into the ASB bank account. Retain this form as a record of the donation. If the donation is for the district, either for the use of the school or for another district program, forward the cash, checks, or other item to the district business office with this form. Explain below whether the donation is for the school or a specific district program. Received at: Received by (Principal or other administrator): Signature: : Received by Governing Board (Name): Signature: : Vicenti, Lloyd & Stutzman LLP Page 12 of 12