Mail Application to:

Bronco Bucks
Cal Poly Pomona Foundation, Inc.
3801 West Temple Avenue, Bldg . 55
Pomona, CA 91768-4038


Bronco Bucks Application
Name Last:_______________________ First:_____________________________ Initial:__ Date:__/__/____
Cal Poly ID#_______________________________________________ Status: Faculty/Staff Student
Address:______________________________________________________________________________
City:_______________________________________ State:______________ Zip:____________________
Deposit Amount:__________________________(minimum $25) Phone# ____________________________
Payment Options
Check Enclosed:_____________ (Make checks payable to: Cal Poly Pomona Foundation, Inc.)
VISA MasterCard Discover Amex
Account #:__________________________________________________________ Exp:_______________
Name on Card:_________________________________________________________________________
Signature of Card Holder:_________________________________________________________________

Terms and Conditions:

Use of the Bronco Card signifies acceptance of the following terms and conditions: The card holder is responsible for observing the transaction amount charged to his/her account at the point and time of sale and the card holder is responsible for monitoring his/her own account balance. Accounts may be closed and a refund of the unused balance requested as follows: Refunds will be made by check within 30 working days from the day of the refund request. Refunds requested after more than one year without activity are not guaranteed. No bonus dollars, if given, will be returned. A $10 processing fee will be charged for refund of unused money. The account holder acknowledges that this service is being offered for their convenience; therefore, it is their obligation to request the return of any unused funds. The account holder is responsible for reporting lost or stolen cards to the Bronco Bucks office as soon as possible. Cal Poly Pomona Foundation is not responsible for misuse of the card until four business hours after the card is reported stolen.