Community Outreach

To begin, please fill out the fields in the form below. One of our representatives will contact you within one business day to complete the process.

This form supports the maximum level of encryption technology your browser allows, up to 256-bit SSL encryption to protect your personal information while it is in transit. Please view our Privacy Policy for more information.

Donation / Ad Request

  • OK Name of Organization is required
  • OK Amount of requested donation or ad is required
  • OK Purpose of the donation or ad is required
  • OK Do you or your affiliation have any accounts with Belgrade State Bank? is required
  • OK Requesting Party is required
  • Phone

    - -
    Optional OK Phone is required
  • Date Needed by

    OK Date Needed by is required
  • OK Make Check payable to is required
  • Mail Check?

    OK Mail Check? is required
  • OK Check to be picked up by is required
  • OK Mailing Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Security Code

  • OK Security Code is required

    Belgrade State Bank reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant full permission to do so.