Charitable Giving Application

All fields marked with * are required.

Name of Organization *

Briefly describe the project/event. *

Event Date *

Specific Event or Program *

Contact Name *

Address *

Phone Number (xxx-xxx-xxxx format) *

Email (valid email address required) *

Amount Requested *

Has First National Bank previously funded this event or organization? *

Does the organization have a current relationship with First National Bank?

If yes, please explain.

Is the organization United Way funded?

Who will benefit from this request and how will the funds be used? *

What do you feel is the importance of the project/event to the local community? *

How will First National Bank be recognized for this donation? *

What other ways could First National Bank participate with your organization through this contribution?

Please note: First National Bank is located in central Iowa and is not affiliated with any similarly named banks in other states.