Sponsorship Request Form

If you are seeking support from Member One, we will consider requests from 501(c)3 organizations that directly benefit the communities we support: Roanoke Valley, Franklin County, Lynchburg Area, New River Valley, and Botetourt County.

Please fill out our request form below. Our committee reviews all requests as quickly as possible, but we recommend you submit your request at least 90 days prior to your event/deadline to allow time for review.

General Submission Information

First Name:

Last Name:

Email:

Phone Number:

Organization Name:

Your title or affiliation with the organization:

Please describe your organization’s mission and/or primary purpose:

EIN from the organization's W-9:

This organization serves people in and is local to Member One’s service area. If not, the request will not be considered.

Region(s) the organization serves: Roanoke ValleyLynchburg AreaNew River ValleyOther

Annual operating budget:

Estimated percentage of your annual budget that goes to administrative costs (salaries, equipment, utilities, fundraising, etc.):

Number of people who directly benefit annually from this organization’s programs and services? 0-199200-500More than 500

I verify this organization is a sanctioned, tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code (or similar code sections), or a sanctioned state or local governmental agency (non-profit organization). Non-sanctioned organizations will not be considered.

Specific Funding Request Information

Minimum dollar amount requested:

Does this request support or sponsor a specific event? Yes - We're requesting funding for a specific fundraising eventNo - We're requesting general funding

Event Name:

Event Date:

Brief description of event:

Approximate Event Attendance:

Has our credit union provided financial support for your organization in the last year? YesNo

If Yes, please describe:

What are your organization’s goals for this funding request?

What specific community need does this request support?

Which of the following best describes your efforts for collaboration with our credit union through this funding request? One-time funding requestShort-term funding and potential long-term collaborative partnershipLong-term collaboration and partnership with the credit unionOther

If Other, please describe:

Caused-Based Alignment

Our credit union is focused on supporting non-profits in our community that are aligned with specific areas of community need.

Does your organization work toward any of the following categories?

Check all that apply.

Financial EducationSupporting Future GenerationsFood SecurityGeneral Wellness

Financial Education

Which of the following audiences does your organization work to provide financial education? (Check all that apply) YouthAdult EducationSeniorsRe-Entry ProgramsOthers

Briefly describe how your organization works to educate our community about financial literacy, personal finance, or economics.

Supporting Future Generations

Which age groups does your organization typically serve? (Check all that apply) 0-9 years (Pre-school or elementary)10-14 years (Middle school)15-18 years (High school)Young Adult

In which of the following ways does your organization support future generations? (Check all that apply) Mentoring and Positive RelationshipsEducationChild AdvocacyChild Safety and SecurityFamilial SupportOther

If Other, please describe:

Briefly describe any additional information as to how your organization supports future generations in our region.

Food Security

In which of the following ways does your organization work to eliminate food insecurity in our region? (Check all that apply) Feeding and food delivery programsProviding access to healthy foodNutrition Education ProgramsPromoting local food and agricultureOther

If Other, please describe:

Briefly describe any additional information as to how your organization supports food security in our region.

General Wellness

In which ways does your organization support general wellness in our region? (Check all that apply) Physical HealthSocial and/or Emotional WellbeingEconomic & Financial WellbeingVocational Health & EmploymentOther

If Other, please describe:

Briefly describe how your organization promotes general wellness in our region.

Volunteerism

Our organization’s employees love giving back to our community through volunteering, spending our time/labor in support of your cause.

What opportunities (if any) would we have to share with you and support your organization through volunteerism? (Check all that apply) Individual volunteering opportunitiesSmall group volunteering opportunitiesCorporate partnership volunteering opportunities

Briefly describe potential volunteer opportunities for our employees through your organization.

Additional Information

Please enter any additional information you’d like us to consider for this request.

Uploads

Upload completed W-9 here:

Must be either a PDF or Word file

Upload project/event/or fundraising materials here:

Upload any additional information or documents here:

Please do not include any URLs in this form as your submission will not be received.

External Site

Sponsorship Request Form