Donation Request Form

• Name of Organization
  OK Name of Organization is required
• Address
  OK Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required
• Contact Person
  Optional OK Contact Person is required
• Contact Phone Number
  OK Contact Phone Number is required
• E-mail
  OK E-mail is required

Request Details

• Please describe your request
  OK Please describe your request is required
• What are the benefits to the community?
  OK What are the benefits to the community? is required

• Do you or your organization have a relationship with First Financial Credit Union?

  • No
  • Yes
  OK Do you or your organization have a relationship with First Financial Credit Union? is required

• Has First Financial donated to your organization in the past?

  • No
  • Yes
  OK Has First Financial donated to your organization in the past? is required
• If yes, when and how?
  OK If yes, when and how? is required

Item Details

• What is the request for?

  • Item
  • Monetary
  • Other
  OK What is the request for? is required
• If other, please explain
  OK If other, please explain is required
• Item Requested
  Optional OK Item Requested is required
• Date by which item is needed
  Optional OK Date by which item is needed is required
• Branch where you would like to pick up items
  Optional OK Branch where you would like to pick up items is required

• Do you need a logo or advertisement?

  • No
  • Yes
  Optional OK Do you need a logo or advertisement? is required

Logo/Advertisement Details

• Logo/ad color

  • Black & white
  • Color
  Optional OK Logo/ad color is required
• Size (width x height)
  Optional OK Size (width x height) is required

• File format

  • PDF
  • JPG
  • EPS
  • Other
  Optional OK File format is required
• If other, please describe format
  Optional OK If other, please describe format is required
• Email address to send logo
  Optional OK Email address to send logo is required
• Date by which logo/ad is needed
  Optional OK Date by which logo/ad is needed is required

• Do you need First Financial banner or signage for your event?

  • No
  • Yes
  Optional OK Do you need First Financial banner or signage for your event? is required

Monetary Donation Details

• If a monetary donation is requested, to whom should the check be made payable?
  Optional OK If a monetary donation is requested, to whom should the check be made payable? is required
• Amount Requested
  Optional OK Amount Requested is required
• Date funds needed (minimum 2 weeks from date presented to First Financial)
  Optional OK Date funds needed (minimum 2 weeks from date presented to First Financial) is required
• Address to which checks should be mailed
  Optional OK Address to which checks should be mailed is required
• OK is required