Community Giving Request Form
Type of donation:
*
Basket
Monetary
Volunteer time
Date of request:
*
-
Month
-
Day
Year
Date
Name of organization:
*
Name of event (if applicable):
*
Date of event or date donation is needed by (if applicable):
*
-
Month
-
Day
Year
Date
Branch pickup location:
*
Cottage Grove Banking Center
Fitchburg Banking Center
Monroe Banking Center
Mineral Point Banking Center
De Pere Banking Center
Platteville Banking Center
Lancaster Banking Center
Elkhart Lake Banking Center
Plymouth Banking Center
Sheboygan Downtown Banking Center
Sheboygan South Banking Center
Sheboygan West Banking Center
Sheboygan North Banking Center
Sheboygan Falls Banking Center
Chilton Banking Center
Glendale Banking Center
Greenfield Banking Center
Is the organization a registered nonprofit?
*
yes
no
Organization's main office address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization's main phone number:
*
-
Area Code
Phone Number
Organization's web address:
*
Does this organization bank with Wisconsin Bank & Trust?
*
Yes, deposit accounts
Yes, loans
Yes, investments
No
Contact name:
*
First Name
Last Name
Contact address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact name's phone number:
*
-
Area Code
Phone Number
Do you personally bank with Wisconsin Bank & Trust?
*
Yes, checking
Yes, savings
Yes, wealth management
No
If Wisconsin Bank & Trust volunteers are being requested, please indicate how many, amount of time and for what purpose:
*
Dollar amount requested:
*
Please describe project in detail including objective, benefits, client base and expected results.
*
What percentage of this donation will go directly to the cause?
*
How many people will be impacted by this donation?
*
How will the bank be recognized if the anticipated donation is approved?
*
If approved for assistance, is your organization willing to participate in a check presentation, interview or other activities as requested?
*
If applicable, please mark the box if the PRIMARY PURPOSE of this request will benefit:
*
Affordable housing primarily benefiting low- or moderate-income individuals.
Community services primarily benefiting low- or moderate-income individuals or geographical areas.
Economic Development (services to businesses that create jobs primarily for low- or moderate-income individuals or tax increment financing (TIF) district loan.
Activities that revitalize or stabilize (Low- or moderate-income geographies, designated disaster area or distressed or under-served non metropolitan middle-income geographies
Neighborhood stabilization program
Where does this donation benefit? Select the area(s) that this investment benefits. Check all that apply:
*
Brown County
Calumet County
Dane County
Grant County
Green County
Sheboygan County
Milwaukee County
Additional Information/Comments:
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