high five form - cbai · gi e s a high five ! high-five program participation # 0( ’.1-08’’3...

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Give us a HIgH FIvE!HIGH-FIVE PROGRAM PARTICIPATION

# of employees x $5: _______

# of Directors X $50: _______

TOTAL ________

OTHER

In Addition to or in Lieu of the High Five, our bank is donating:

____________

O Please invoice us.

All donations are 100% tax deductible.

Please make checks payable to the CBAI Foundation for Community Banking.

All donations will be credited to the bank unless otherwise specified.

T H A N K Y O U !Yo u r N a m e :

B a n k :

C i t y :

Ready to High-Five

us now?Make your

tax-deductible check

payable to the

CBAI Foundation

and mail to

901 Community Drive,

Springfield, IL 62703

THANK YOU!

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