Rcu Donation / Image Ad Request

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RCU DONATION / IMAGE AD REQUEST
Today's Date ____
Organization
Tax ID #
Address
City
ST
Zip
Organization's Purpose Fund Raiser for Local Charities
Number of Members
Is Organization a Member of RCU? ____ Yes
_______ No
Officers of the organization are:
Name of representative requesting donation:
Is representative a Member of RCU? _ ___ Yes
____ No
Phone Number
Fax Number
Email
Best time to contact you via telephone
Donation request (please describe here and attach any letter, sample ads, etc.)
.
Donation Requested* $
Target amount to raise $
Purpose of fund-raiser
How many people will this serve/benefit/impact?
What will the funds be used for?
What percent of yearly gross income raised goes to:
Administration ___ _____%
State or National Organization ___ _____%
Special Event
Date
If for an ad, what is the deadline to submit the ad?
What sizes are available (include size by inches)?
What color ink?
Include a copy of publication or RCU ad from previous year.
Name of RCU team member(s) who belongs to this organization (if known)
Additional Comments:
*If request is greater than $1,500, please enclose a copy of your financial statements.
Return to: Royal Credit Union
For Office Use Only
ATTN: Vicki Hoehn, VP – Community Engagement
____ Accepted
Phone: (715) 833-8246
Fax: (715) 552-3072
____ Denied
PO Box 970
Eau Claire, WI 54702-0970
Donation requests are reviewed on the first Tuesday of each month.
1382 RCU 12/94 (Rev. 2/15)

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