2024 Beneficial State Bank Sponsorship Request Form

We receive a large volume of sponsorship requests to review each year. Filling out this form will help us understand your organization's work and the purpose of the sponsorship.

This form has an optional "Save & Return" feature that allows you to save your progress and complete the form later if needed. Creating a login takes just a minute.

Please review the sponsorship eligibility criteria carefully before completing this form:
• Only 501(c)(3) nonprofit organizations AND 501(c)(3) fiscally sponsored-organizations are eligible.
• Currently, sponsorships are dedicated to the communities we serve within CA, OR, and WA.
• Please submit your request at least 60 days in advance of desired arrival of the funds.

• Sponsorships may be used to support projects including, but not limited to, capital campaigns, program operation, and events (online & in-person). However, they may not be used to support partisan political activity or intervention or participation in any political campaign on behalf of or in opposition to any candidate for public office.

Save & Return

Avoid losing your progress by setting up a user account.

Please describe the purpose of your request (e.g. event, fundraiser) and its connection to Beneficial State Bank & Beneficial State Foundation’s mission: *

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Organization's Development Team Contact

This person will be the main contact for updates on your application

First Name *

Last Name *

Email Address *

Organization Information

Name of Organization Requesting Sponsorship *

Organization's Phone Number *

Organization's Mailing Address *

City *

State *

Zip Code *

Closest Bank Branch to organization *

Organization's Website URL *

Name of Executive Director or CEO *

ED or CEO's Email Address *

Is requesting organization a 501(c)(3)? *

Yes

No

Please enter your 501(c)(3) Nonprofit Organization's Employee Identification Number (EIN), including the hyphen: *

Please upload your organization's IRS 501(c)(3) determination letter *

Does the requesting organization have a 501(c)(3) Fiscal Sponsor?

Yes

No

Fiscal Sponsor's Information

Please indicate the name of your 501(c)(3) Fiscal Sponsor: *

Please enter your Fiscal Sponsor's 501(c)(3) Employee Identification Number (including the hyphen) *

Please upload the Fiscal Sponsor's 501(c)(3) determination/affirmation letter. *

Please attach the fiscal sponsorship agreement or email from the sponsoring organization confirming your fiscal sponsor relationship.

Fiscal Sponsor Organization's Mailing Address: * 🛈

Fiscal Sponsor Organization's City: *

Fiscal Sponsor Organization's State *

Fiscal Sponsor Organization's Zip Code: *

Name of Fiscal Sponsor's ED, CEO, or Financial Director *

Fiscal Sponsor ED, CEO, or Financial Director's Email Address *

Organization's Impact

Please provide a brief paragraph describing organization's mission, programs, and communities/individuals served. *

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Please indicate which of the following counties will be primarily served by this sponsorship.
(select all that apply) *

Number of beneficiaries served annually: *

Please indicate if your organization falls into any of the following mission sectors. *

Does your organization offer community services, affordable housing, or small business development services that primarily serve Low to Moderate Income (LMI) individuals, communities, or small businesses? * 🛈

Yes

No

Does the sponsorship request support any of the following CRA activities?
Note: Low- and Moderate-Income (LMI) means individual income that is less than 80% of the Median Family Income (MFI).
Click HERE to determine the HUD MFI for your area.
. *

Community Services: services to a majority Low- and Moderate-Income (LMI) individuals focused on education, childcare, health or social services.

Affordable Housing: including multifamily rental housing to LMI individuals.

Economic Development: support and financing to small businesses / farms leading to job creation / job retention for LMI individuals or in LMI areas

Activities that Revitalize or Stabilize LMI geographies, designated areas, or designated distressed / under-served middle income areas.

If you serve Low to Moderate Income (LMI) individuals or small businesses, what specific programs or services do you offer AND approximately what % of your clients are LMI? Please describe:

How is this percentage determined and what criteria is used to determine LMI or small business eligibility?
(i.e., collect income documentation through intake process, majority served are MediCal recipients, use HUD guidelines, Free & Reduced Meal Program Eligible)

Will this sponsorship requested directly or indirectly benefit LMI individuals or small business owners?
If so, what is the anticipated number of LMI individuals or small businesses to be served, and briefly explain the impact that this request will have on the target population including anticipated changes in knowledge, condition and status. *

Please indicate whether any of the following volunteer opportunities are available at your organization or local community that our volunteers can participate in: *

Provide the contact information of the volunteer coordinator for your organization, if applicable:

Name

Email Address

Diversity Survey Questions (optional)

Responding or skipping the following two (2) questions will NOT affect the status of your application. Responses are collected solely for impact data.

We invite you to indicate if 50% or more of the staff, leadership, and board identify as and serve any of the following groups:

For the next question, please note that a BIPOC-led nonprofit organization is defined as one that meets all of the following three criteria:

• 50% or more of the staff and leadership are non-white,

• 50% or more of the board is non-white, and

• the mission statement and charitable programs aim to predominately serve and empower minority communities.

If your organization is BIPOC-led nonprofit organization (definition above), which of the following best describes it?

Project/Program/Event Details

REMINDERS:

Sponsorships may be used to support projects including, but not limited to, capital campaigns, program operation, and events (online & in-person).

However, they cannot be used to support partisan political activity or intervention or participation in any political campaign on behalf of or in opposition to any candidate for public office.

See the top of this form for more information about the eligibility criteria.

What is the name of your Project, Program, or Event? *

What will be supported by the sponsorship request? (select all that apply) *

Event

Program

General operating support

other other

Do you have a confirmed date?
(If not, that's okay! Please just keep us updated.) *

Yes

No

Event Date (if applicable) +

Event Time (if applicable)

Name of Venue/Location (if applicable)

Event's Street Address (if applicable)

Event's City

Event's State

Event's Zip Code

Event Website URL (if available)

Requested Sponsorship Amount
(most sponsorships were less than $1,000) *

If individual tickets are available for purchase for this event separate from sponsorship levels available, please provide pricing details here:

Expected number of attendees at your event (if applicable)

Please list all other confirmed sponsors for this event at this time. *

If applicable, please describe any benefits for the requested sponsorship amount (e.g. number of complimentary event tickets, logo placement, social media recognition, speaking opportunity)

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If any tangible benefits with value will be provided to employees or guests of Beneficial State Bank as part of the sponsorship (e.g. meals at fundraising or networking event, golf green and cart fees at golf tournament, entrance fees to special event such as sporting event, amusement park, etc.), enter the Per Person fair market value or cost of the tangible goods, services or benefits that will be provided.
Enter "N/A" if Not Applicable. *

Please use this field to upload sponsorship prospectus or other materials

Please describe if you have received any past sponsorship from Beneficial State Bank or Beneficial State Foundation—specifically the year(s) and amount. If so, summarize the community impact and outcomes resulting from that support.

Communications

Logo Usage (Disclosure)

In efforts to amplify the important work of changemakers like you, Beneficial State Bank and Beneficial State Foundation (collectively as "Beneficial State") may use your logo in our nonpublic and public channels (i.e. reports, websites, and social media). This information may be shared with regulatory entities as well as current and future partners including with media outlets reporting on Beneficial State. The primary purpose for sharing this information is to clarify or highlight the missions of Beneficial State, clients we serve, and organizations we sponsor. Beneficial State does not share private information with 3rd parties for the purpose of soliciting business.

However, you may opt-out of logo usage on our public-facing channels by checking the box below OR contacting marketing[at]beneficialstate.com

(Opt-out) "Beneficial State may not use our organization's logo on public-facing channels."

If you prefer that we use specific logo files for such purposes, you may upload them here. 🛈

Our sponsorship program is open to all 501(c)(3) nonprofit organizations. However, please let us know if you are a Beneficial State Bank client. *

Beneficial State Bank client

Not a client of the bank

Have you completed our Client Release Form? We would like to promote your organization's work on social media! *

Yes!

Not yet.

No.

Okay! We encourage you to save the link to fill it out when you have a chance.
Note: it will open in new window so it does not interrupt your progress on this form.

Who is your primary contact at the bank, and how are they involved with your org (account officer, Board of Directors, etc.)? *

How did you hear about the Sponsorship Program? *

Please indicate if you are currently following Beneficial State Bank and Foundation on our social media channels: *

Please share the URLs to your social media channels.

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follow Beneficial State Bank

Facebook: @BeneficialStateBank
Twitter: @BeneficialState

Instagram: @BeneficialState

LinkedIn: Beneficial State Bank

follow Beneficial State Foundation

Facebook: @BeneficialStateFoundation
Twitter: @BeneficialStFdn

LinkedIn: Beneficial State Foundation

Any comments or additional information you'd like us to know?

By entering your name below, you are confirming that you are authorized to submit this sponsorship request on behalf of the non-profit organization:

Full Name of person completing this request *

Title *

Phone Number *

Email Address *