Donation/Sponsorship
Request Form

Please complete this form for all organizations requesting financial support from Farmers State Bank. We ask the request be submitted at least two weeks in advance for proper consideration. Those not providing ample time for consideration may limit their opportunity for support.

Amount Requested *

Date Funds Needed By *

Name of Organization *

Contact Person *

First

Last

Contact Phone Number *

Contact Email Address *

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Incorporated as an Illinois Non-Profit organization? *

Are Farmers State Bank employees involved in your organization? *

Describe how the funds will be used (please be specific) *

How will Farmers State Bank be recognized for its support of your organization *

Does your organization bank with Farmers State Bank? *

Optional File Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Upload Cover Letter and/or Brief Description Documentation (.pdf files only, 5MG max size each)

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Donation/Sponsorship Request Form

Donation/Sponsorship
Request Form