Donation Request Form

Personal Information:

  • OK First Name is required
  • OK Last Name is required
  • OK Business/Organization Name is required
  • OK Relationship to Business/Organization is required
  • OK Email is required

Contact Information:

  • OK Residential Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • OK Phone Number is required
  • Optional OK Extension (if applicable) is required

Donation Information:

  • Are You a Current BankVista Client?

    OK Are You a Current BankVista Client? is required

  • Donation Category

    OK Donation Category is required
  • OK Describe Your Requested Donation is required
  • OK Event Name or Donation Purpose is required
  • OK Event Date or Donation Needed By Date is required
  • Optional OK Projected attendance (if applicable): is required
  • OK Event Details / How You Will Use the Donation is required

  • Have you previously received a donation for this event from BankVista?

    Optional OK Have you previously received a donation for this event from BankVista? is required

  • Does BankVista need to mail promotional items to a different address?

    OK Does BankVista need to mail promotional items to a different address? is required

Promotional Items Mailing Address:

  • OK Street Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Please enter any additional information you would like us to know... OK Additional Comments is required
  • OK is required