Divvy Card Application (Jotform Sign)

Divvy Card Application

Please complete this form to request a card for a project staff member.
Project Name
Fiscally Sponsored Projects should choose their project name. MSC Core staff, please choose Movement Strategy Center.
Supervisor
Cardholder Name (as it should appear on the card):

First NameLast Name
Title
Cardholder Email Address
example@example.com
Cardholder=Project Director
The cardholder email above does not match the email on file for the project's director. If you believe this is an error or need to update your email address, please contact your project advisor, {projectAdvisor}.
Please note that this application will require project director approval.
Physical or Virtual Card
When should the temporary card be closed?

MonthDayYear
Date
Please note that physical cards may take up to two weeks to arrive.
Please note that virtual cards can only be used for online purchases.
Mailing Address (please use your home or office address instead of MSC's address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
By submitted this form, I acknowledge that the supervisor or project director will be responsible for reviewing and approving this card's transactions and supporting documentation monthly on a timely basis.
Project Director (hidden)
Project Director/Supervisor Email (hidden)
example@example.com
Project Advisor (hidden)
Project Name as Text (hidden)
Project Advisor Email
example@example.com
PA/Ops Approval Email Language
Should be Empty: