Donation request form

If you would like to request funding from Greater Iowa Credit Union, please complete this online request form.

Indicates a Required Field
Type of request:
Organization/agency name:
Address:
City:
State:
Zip code:
Contact person:
Email Address:
Telephone:
Mobile phone number:
Date of application:
Amount requested:
Funds needed by:
How do you plan to use the funds?:
Is this organization tax exempt:
Yes
No
Verification Code: