Infrastructure Loan Application

STEPHEN P. DEPALMA INFRASTRUCTURE LOAN FUND

LOAN APPLICATION FORM

Please provide the following information:

Individual Submitting Application

Phone Number

Chapter

Date

Requested Loan Amount

Intended Use of Funds

Chapter House

Address

Ownership Information

Chapter Information

In House Dues

Out of House Dues

Rent (please note total monthly or annual)

House Capacity

# Living In this Year

Accounts Receivable End of Last Month

Accounts Payable End of Last Month

Mortgages (if applicable)

1. $

2. $

3. $

Balance Holder

Held Where?

Amount in Current Checking or Savings Accounts

Use of Funds

Explain in detail so persons removed from your situation will understand what you intend to do with the money. If repair work is involved, include full details and contractor’s estimate. This is important as distribution of funds requires that the project be fully detailed.

I confirm that the chapter archon, treasurer and a representative of the alumni/housing corporation have collaborated on the completion of this form. This request is made on behalf of the house corporation and undergraduate chapter. Proceeds from this loan will be used only as explained in the preceding application. This request is made on behalf of the house corporation and undergraduate chapter. Proceeds from this loan will be used only as explained in the preceding application.

I confirm

Our Location

3701 Arco Corporate Drive, Suite 500 | Charlotte, NC 28273

Contact Our Office

Office: (734) 997-9777

Email: admin@alphafraternitymgmt.com