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Organization Name
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Type of Request
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Grant
Sponsorship
Other
Date Needed By
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Month
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Day
Year
Amount Requested
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Is your request for an event?
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Yes
No
Project Name
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Event Name
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Event Date
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Month
-
Day
Year
Event Venue
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Venue Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How would this donation be used?
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Who would this donation benefit?
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How many people would this donation benefit?
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Would this donation primarily benefit low-income individuals?
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Yes
No
What percentage of beneficiaries would be low-income?
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What benefits would the bank receive from this donation?
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Advertising
Dinner Attendee
Tickets
Other
None
Describe if Other
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How much of this sponsorship would be used to cover benefits received by the bank?
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e.g., meals, golf round, tickets, advertising, etc.
Please attach any additional support documentation.
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Does your organization have a need for any of the following?
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Board members
Financial education workshops
Service projects
Other
None
Further explain these needs and how Western Security Bank might help meet them.
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Submitted By
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Position/Title
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
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example@example.com
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