Sponsorship and Contribution Request Form
WASHINGTON COUNTY
Name of Organization
*
Address
*
City
*
State
*
Zip
*
Type of Organization:
*
Non-Profit
For Profit
Does this organization already have an account at State Bank?
*
Yes
No
Contact Person
*
Contact Email
*
example@example.com
Contact Phone Number
*
Bank employees with whom you have a relationship:
Description of contribution and amount requested:
*
0/75
Please describe the positive impact this contribution would have on your organization, the benefits to the community, how many individuals this would impact, and potential advantages to the bank:
*
0/100
Date Contribution is Needed By:
-
Month
-
Day
Year
Date
(Note: All requests are reviewed by our committee, which meets on the first Friday of each month.)
Please verify that you are human
*
Preview PDF
Submit
Should be Empty: