Donation Request | OH Community Support

Name of individual or organization request is for:

If a monetary donation is being requested, who should the check be made payable to:

Address:

Cities or counties served:

General purpose of organization/event:

Brief description of the request, including how many people are estimated to be helped, how donation will be used and if low to moderate income groups will be served:

Have you contacted any other organizations for donations?:

YesNo

Will the Bank receive publicity or recognition?:

YesNo

Are any Premier Bank employees involved in this effort?:

YesNo

Will Premier Bank have a booth or be able to supply bank product information at this event? :

YesNo

Is there anything else you would like to include or clarify?:

Donation Request Form

Details of Request

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Donation Request Form

Details of Request

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