Community Spark

We’re ready to roll up our sleeves and get involved with your initiative.

Organization's Details

Tell us about your organization.

Organization name

EIN

Website

Phone Number

Address

City

State

Postal Code

What is your organization's purpose?

Is the organization a 501(c)(3)?

Yes

Is the organization a Field & Main customer?

Yes

Primary Contact Details

If we have questions, who should we contact?

First Name

Last Name

Title

Phone

Address

City

State

Postal Code

Are they a Field & Main customer?

Yes

Program Name

Program Date

Amount Requested

Funds Needed By

Describe The Geographic Location/Area Most Impacted By The Donation

Intended Use of Funds

Please provide a detailed description of the program. Including, who will benefit from the funds, how it will impact the community and specific programs or services provided.

Sponsorship Benefits And Notes

IF ANY, PLEASE LIST ALL SPONSORSHIP BENEFITS, INCLUDED BUT NOT LIMITED TO: BANNERS, PROGRAM RECOGNITION, ADVERTISEMENT, BOOTH SPACE, ETC.

Capital Campaign

IF THIS IS A CAPITAL CAMPAIGN, PLEASE SHARE YOUR OVERALL PROJECT BUDGET AND AMOUNTS YOU HAVE SECURED FROM OTHER ORGANIZATIONS.

Attachments

organization

EIN:

primary contact

Email:

program

Requested Amount:

Needed By:

We work to strengthen the communities we serve by investing in organizations and initiatives that share in our vision for developing healthy, vibrant and collaborative communities.