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.

  • OK Amount Requested is required
  • OK Date Funds Needed By is required
  • OK Name of Organization is required
  • OK Contact Person is required
  • OK Contact Phone Number is required
  • OK Contact Email Address is required
  • OK Mailing Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

  • Incorporated as an Illinois Non-Profit organization?

    OK Incorporated as an Illinois Non-Profit organization? is required

  • Are Farmers State Bank employees involved in your organization?

    OK Are Farmers State Bank employees involved in your organization? is required
  • OK Describe how the funds will be used (please be specific) is required
  • OK How will Farmers State Bank be recognized for its support of your organization? is required

  • Does your organization bank with Farmers State Bank?

    OK Does your organization bank with Farmers State Bank? is required
  • OK If not, where does your organization currently bank? is required
  • OK How much is your current bank contributing to your organization? is required
  • OK is required