Request Form - Square Card Reader Access | Texas State Employee Charitable Campaign

SECC Region (Select one from the menu)

SECC Square Card Reader Policy

I have read the SECC Square Card Reader Policy, will abide by the requirements set-out in this policy and agree to return a signed copy of it to my Local Campaign Manager (contact info here), prior to my being allowed to use the Square software.

*IMPORTANT*

1. Please review the Square Card Reader Process overview before proceeding with this request. Also, here is brief walkthrough of the process.

2. Complete the request form below to reserve a SECC Square user account.

3. Complete a pledge form for each special event (including event name, total amount raised, and charity code(s). Download a pledge form here: Resources | Texas State Employee Charitable Campaign (secctexas.org)

4. Submit completed pledge form after each event to your SECC Local Campaign Manager.

5. Alert your SECC Local Campaign Manager when you have finished using the Square software during this year's SECC.

State Agency, College or University Name

Work Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Coordinator Name

Coordinator Email

Coordinator Phone

Supervisor Name

Supervisor Email

Supervisor Phone

Date that Square access is needed by

Date and Time(s) of Event(s)

Event(s) where the Square software will be used? Please describe.

Which of the following would you prefer to use for Square transactions