Request for Contribution Funding › Farmers Bank & Trust

Farmers Bank & Trust has a giving mission to give back to our communities. Please complete the form below to be considered for contribution funding or giveaway items.

* Required Field

Organization*

Are you a 501c(3) organization?*

Tax ID Number

Mailing Address*
(Include: street address, city, state, zip code)

Contact Person*

Phone*

Title

Email Address*

Funding contributes to:

Veterans
Law Enforcement/Civic Workers
Education
Wellness

Project Summary: Please briefly describe the project you are requesting for funding assistance. (Include: what, who, how many are involved, goal/objective, other sources of funding, etc.)

Please describe how Farmers Bank & Trust's potential donation to this project would also be beneficial to the Bank:

Does your organization currently have an account at Farmers Bank & Trust? (Example: loans, checking, savings, credit card etc.)

Total Project Cost

Amount Requesting ($)*

Request for Promo/Giveaway Item

Number of Items Requesting

If this is your first time to apply for a contribution from Farmers Bank & Trust, please attach a copy of your organization’s letter from the IRS indicating your charitable 501c(3) tax-exempt status and Board of Directors list. Please feel free to attach any other helpful documentation.

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