Community Impact Award Request

Community Impact Award Request

Requests received by 5pm on:

March 1st

June 1st

September 1st

December 1st

Will be communicated our decision by month-end via email.

Today's Date*

Donation Amount Requested*

Max $5,000

Giving Category*

Bright Futures:

We support programs whose goals are to create and provide opportunities for early childhood and K-12 youth to help them get the most out of their education, as well as promote their well-being to help children from all backgrounds reach their full potential.

Resilient Families:

Strong and resilient families are central to our community's well-being. We support programs and non-profits who focus on helping families find a work life balance, rebuild in the wake of disasters, and who focus on families' economic welfare.

Community & Economic Development:

We are only as strong as our community. Core Bank supports programs, non-profits, events, activities and initiatives that contribute to our communities and their economic development.

Select

Organization Requesting Donation*

Organization Website*

Organization Mailing Address*

Organization City*

Organization State*

Organization Zip*

Organization Leader First & Last Name*

Organization Leader Email Address*

Organization Phone #*

Phone

Non Profit?*

Accepting applications only from qualified, tax-exempt, 501(c) nonprofit organizations.

Select

Mission Statement*

Core Bank Employee(s) involved with Organization?*

Select

Name of Employee(s)*

% of Low to Moderate Income (LMI)*

Select the range that corresponds to the percentage of your clients that are low-to-moderate income.

Select

LMI Qualifiers*

US Census

Free & Reduced Lunch

Client Surveys/Applications

Other

Other LMI Qualifiers*

Select the activity(s) that most closely aligns with your organization's mission*

Community Services includes childcare, educational, health, or social services.

Activities promote Economic Development by financing small businesses and farms with gross annual revenues of $1million or less; and/or promotes permanent job creation, retention, and or improvement for low- or moderate-income people or areas, or redevelopment by federal, state, local, or tribal governments.

Revitalize or Stabilize means the activity attracts new, or retains existing, businesses or residents and has been approved by federal, state, local, or tribal government including Enterprise Community or Empowerment Zone plans.

Provides affordable housing for LMI individuals/families

Provides community services for LMI individuals

Supports activities that promote economic development

Revitalize or stabilize LMI geographies

N/A

Interested in Volunteer Support by Core Bank?*

Select

Please explain Volunteer Support needs*

Other Misc. Notes | Comments

Organization Information Materials*

Drag and drop files here or

Please make sure all of the following are uploaded above.*

Mark the boxes of what has been uploaded.

Please use the Community Impact Award Guidelines for guidance on all that should be included with each document

Demographics Strategy Details

Organization Annual Budget

Finances; Program Budget & Other Funding Sources

Organization Documents (i.e. W-9, Determination Letter, Articles, etc.)

Program Description

Evaluation & Measurement Details

Program Timeframes

Program Area Served

Volunteer Engagement Details

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