Community Involvement Request

Step 1 of 2: Submit

Because we truly are a local banking institution, CNext is devoted to community involvement. Our Board of Directors, management, and employees are caring people who live and work with our fellow citizens to make our community a wonderful place. We show our dedication through community participation in a variety of programs and in conjunction with multiple institutions and organizations.

If you would like to request financial or other support for your non-profit organization within our service area, please fill out the online form below. Please note that all requests should be made at least a month in advance. All requested documentation must be included with the application.

We carefully consider all applications. The volume of requests received is significant; therefore, we may not be able to honor your specific request.

Organization Name Contact Name Telephone Number Email Address Mailing Address

Relationship to the organization making request Volunteer Employee

Is your organization a 501 (c) (3) Yes No "Not Sure"

If you checked not sure in the above field, please verify that information before submitting your request. Thank you in advance.

If you checked "yes" above for 501 (c) (3) status, you must submit a copy of the letter from the IRS confirming your organization’s 501(c) (3) status. Email: community@cnext.bank

Which service area does your request impact? Lincoln Parish, Louisiana Ouachita Parish, Louisiana Ashley County, Arkansas Other

What is the mission of your organization

What is the nature of your request? (check all that apply) Funding Promotional Items Volunteer Assistance

If your request is for funding, what is the amount you are requesting? If your request is for funding, how will our contribution be used? If your request is for volunteer assistance, what date are volunteers needed?

If request is for volunteers, how many volunteers are needed? If your request is for volunteer assistance, please describe the volunteer work needed.

Will there be advertisements or other promotions featuring Century Next Bank? Yes No

If yes, will the Century Next Bank logo be needed? Yes No

Is there any other information you would like to share about your request?