Donation / Sponsorship Request Form

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Date Request Needed

Location of Event

Organization Name

Address

Person Making the Request

Title

Phone

Fax

Amount Requested

Are you a 501C organization?

Organization's Primary Purpose/Mission

Describe the impact this donation will have on your organization as well as the community.

Will there be any advertisement or promotions featuring GNB Bank? If yes, please explain.

Does the organization have a relationship with GNB Bank? Please explain.

Previously, has GNB Bank donated to this organization?

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