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Donation/Sponsorship Request Form

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Date(Required)

MM slash DD slash YYYY

Name of Charity Organization(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Fax

Contact Person(Required)

First Last

Email(Required)

Date of Event/Donation Deadline(Required)

MM slash DD slash YYYY

Is someone that works at BankChampaign affiliated with your organization?(Required)

Yes

No

Name of person at BankChampaign affiliated with your organization(Required)

First Last

Role of person at BankChampaign affiliated with your organization(Required)

What is the reason for this request?(Required)

How will the donation/sponsorship money be used?(Required)

Will the donation/sponsorship funds be kept locally?(Required)

Yes

No

Does your organization bank with us?(Required)

Yes

No

What type of accounts do they maintain?(Required)

Checking

Savings

Personal Loans

Credit Cards

Debit Cards

Do you personally bank with us?(Required)

Yes

No

Did your organization’s bank donate?(Required)

Yes

No

What level or amount did they donate?(Required)

Did you donate for this specific cause?(Required)

Yes

No

Will you need our logo for sponsorship advertising?(Required)

Yes

No

Detail the marketing/advertising/PR value the bank receives from this donation/sponsorship

Have we donated to your organization in the past?(Required)

Yes

No

Past donation date from BankChampaign(Required)

MM slash DD slash YYYY

Past donation level or amount from BankChampaign(Required)

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© 2025 BankChampaign

All rights reserved.

Phone – 217-351-2870

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Member FDIC
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Privacy Policy

Bankchampaign is a proud supporter of

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© 2021 BankChampaign
All rights reserved.

Phone – 217-351-2870

Facebook-f Twitter Linkedin-in

© 2025 BankChampaign

All rights reserved.

Phone – 217-351-2870

Home
Member FDIC
Equal Housing Lender
Privacy Policy

Home
Member FDIC
Equal Housing Lender
Privacy Policy

Bankchampaign is a proud supporter of

Facebook-f X-twitter Linkedin-in Instagram

© 2025 BankChampaign

All rights reserved.

Phone – 217-351-2870

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