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Amplify CU
PO Box 85300
Austin, TX 78708
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Thank you for this opportunity!

It is the policy of Amplify Credit Union to give equal consideration to all charitable donation and sponsorship requests that meet the credit union’s standards for eligibility. Individuals or organizations seeking a charitable donation from Amplify Credit Union will be asked to complete and submit the following Charitable Donation Request Form for review and consideration by the Amplify Credit Union Charitable Contributions Committee (CCC).

Please fill out the form with as much information as possible so that we can fairly and accurately determine how Amplify can contribute to your organization, event, initiative, or cause.

Basic Information
Your Name*
Are You an Amplify Member?*
Name of Organization*
Best Contact Phone*
Best Contact Email*
Organization Mailing Address*
Organization Service Area*
Organization Mission/ Purpose*
What is your role with the organization?*
What amount or what items are you requesting?*
Have you filled out a W-9 for Amplify Credit Union in the last 2 years?*
Contribution Deadline
Organization Details
Which category most closely describes your initiative?
Explain why you selected the above answer
Who will benefit from this initiative/ cause/ event
(students, special needs, health conditions, etc.)?
How many people will benefit from this initiative/ cause/ event?
Briefly describe the goals of your initiative/ cause/ event
Briefly describe how this contribution will benefit
the community served by Amplify Credit Union
How will Amplify Credit Union's support measurably
impact your results, and how will you measure that success?
Amplify's Involvement
List any opportunities for Amplify Credit Union
to advertise at your event
List any volunteer opportunities for Amplify Credit Union
employees or members to help with your event/ cause/ intiative
Form Certification
  I certify that the information provided in this form is
accurate and true to the best of my knowledge.
I understand that, if approved, the donation check
will be made payable to the organization.
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