ACORN SOCIETY ENROLLMENT AGREEMENT

 I(We) wish to establish a component fund by using your "Acorn Fund" concept.  Under this concept all contributions and earned investment income accumulate in an investment account ("the Account") until the funding date.  On the funding date hereafter described, the amounts accumulated shall be used to establish a named component fund of the Merrick Foundation, Inc.

I(We) would like to build an Acorn Fund through:

               Regular deposit plan at the rate of:

                        $ ____________ per month (minimum $50)

                        $ ____________ per quarter (minimum $150)

                        $ ____________ per year (minimum $600)

              Life insurance program: annual deposit plan of $ __________ per year (minimum $1,000

per year) for five years.

              Other $_______________

I(We) understand that the Foundation has the right to invest my (our) contributions in such manner as its Investment Committee may, in its discretion, determine.

My (Our) contributions shall be made as follows: 

              ___________ Personal check

              ____________ Direct withdrawal from my (our) account at:

_____________________________________________                 _____________________________________________

BANKING INSTITUTION                                                   ACCOUNT NUMBER

_____________________________________________

TYPE OF ACCOUNT

(NOTE:  Direct withdrawals must be on a monthly basis.)

It is my (our) intention, at this time, to continue my (our) contributions until: 

              A total of $_________________ has been contributed.

              The total value of the Account equals $________________.

              Other (describe) ________________________________________________________________________.

It is my (our) request that all contributions and income earned thereon be accumulated in the Account until such time (the "Funding Date"): 

as the value of the Account equals:

__________ $5,000 (the funding minimum for creating an unrestricted fund or fund designated to one agency only)

__________ $25,000 (the minimum for becoming a "Benefactor" for the Foundation.)

__________ $ (other amount) ________________

until (date) ________________.  This date has been selected as it marks (describe occurrence, anniversary or commemorative event, e.g. our 50th wedding anniversary, my 100th birthday) ________________________.           

In the case of a life insurance program, I (we) agree that the Funding Date will be the date of death of the insured. 

I (We) understand that my (our) contributions are gifts to the Foundation to be used solely for its purposes and that neither my (our) contributions nor the Account or any part thereof will be refunded or distributed to me (us).

Acorn Society Enrollment Agreement  -  Page Two 

I (We) agree that if I (we) cease making contributions as set forth above or if on the Funding Date the value of the Account does not equal the funding minimum, the Foundation may in its discretion allow the account to continue accumulating

until it reaches the funding minimum or liquidate the account and distribute the balance thereof to the Foundation's general fund or for such other purposes as the Board may determine.  However, I (we) understand that once I (we) have contributed an amount at least equal to the Funding Minimum to the Account, I (we) shall be deemed to have met the minimum funding standards for the establishment of a component fund of the Foundation even if, because of fluctuation in investment values, the value of the Account on the Funding Date is less than the Funding Minimum.  In such event, the Funding Date and the distribution of the Account shall be deferred until its value equals the Funding Minimum at which time the Account shall be liquidated and used to establish a component fund of the Foundation as hereafter provided.  I (We) further understand that the Foundation reserves the right to increase the Funding Minimum from time to time if because of changed circumstances it considers it impractical or uneconomical to administer a fund in the amount of the current Funding Minimum.  In such event, the Funding Date and the distribution of the Account shall be deferred until its value equals such increased Funding Minimum as the Foundation may hereafter establish. 

On the Funding Date, the Account balance shall be used to establish a component fund (the "Fund") of the Foundation as follows:

            (a)  The Fund shall be known as the ______________________________________________________

                  Fund and shall be identified as such in the course of the administration thereof.

             (b)  Distributions from the Fund shall be made at least annually in a manner consistent with

                 Foundation's governing instruments as they now exist or may be hereafter amended.

                   Grant distributions from the Fund shall be applied in the following manner:

                   ______%  unrestricted, used for such purposes as the Board, in its sole discretion, may determine.

                   ______%  field of interest, used for the special purposes of______________________________

                                     _____________________________________________________________________________

                    ______%  designated for the benefit of ____________________________________for the purpose

                                  of ___________________________________________________________________________.

                   ______%  advised, allowing ongoing recommendations by the donor.

I (We) further understand that I (we) or other donors may add to the Account and/or Fund by gift or bequest at any time for the purpose of bringing it up to desired levels and/or increasing its value. 

Notwithstanding anything herein to the contrary, the Fund shall at all times be held and administered in accordance with the provisions of the Foundation's Governing Instruments, all of which are hereby accepted and agreed to by the undersigned, including those provisions relating to amendment, termination and variance from donors' directions.  The undersigned acknowledge(s) that under the provisions of the Governing Instruments and applicable tax regulations, the Board of the Foundation has the power and the duty to modify any restriction or condition on, or direction as to, the timing, manner or character of distributions or on or as to distributions for any specified charitable purposes or organizations if, in the sole judgment of the Foundation's Board (without approval of any participating trustee, custodian or agency), such direction restriction or condition becomes, in effect, unnecessary, incapable of fulfillment or inconsistent with any distribution policy adopted by the Foundation or with the charitable needs of the Merrick county communities (as defined in the Governing Instruments). 

If the foregoing is acceptable to the Foundation, kindly so indicate by dating and signing the enclosed copy of this Enrollment Agreement in the space provided below and returning it to my (our) attention.  Upon such acceptance, this letter will constitute our agreement with respect to the Account and/or Fund and all prior discussions and agreements concerning the Fund are merged herein and made a part hereof.

__________________________________________________            Accepted this _______day of____________, ______

SIGNATURE                                          DATE                for the Foundation

__________________________________________________         ______________________________________________

SPOUSE SIGNATURE                              DATE                Executive Director

__________________________________________________

ADDRESS

__________________________________________________

PHONE