Donation Request

Today's Date: 
Date of Event (or) Date Support is Needed:  
Name of Organization: * 
Organization's Phone: *  
Address (mail check to): * 
Contact Person: * 
Phone: *  
Email: *  
Is this Organization:


Is this organization a Dakotaland Federal Credit Union Member?: * 
Does this organization receive United Way Funds?: * 
Will Dakotaland Federal Credit Union receive any recognition | public relations?: * 
If so, in what way?:
Has Dakotaland Federal Credit Union given support to this organization in the past?:
How was that support declared through a donation of:


Support Requested (complete all that apply):


Please provide a description for the support requested above: * 
For what purpose is the support to be used?: * 
Validation:
(For Spam Prevention)