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We are interested in the following partnership opportunities: (check all that apply)*

Teaching financial education classes, free of charge Partnering with a local bank or credit union Organizing one-on-one financial counseling for your clients Hosting an informational brown bag lunch Setting goals for savings/debt reduction Placing posters and materials in public areas Providing information by mail or e-mail Receiving an informational brochure about Bank On Rockford
My employees/clients need information in a language other than English: (check all that apply)

Spanish Polish Other (please specify below)
Other language
Which of the following best describes your organization*

Workforce development Affordable housing Government agency Local employer Labor union Financial institution Immigrant services Family support
Which financial institutions are you most interested in partnering with: (check all that apply)*

Alpine Bank AMCORE Bank Bank of America Chase Fifth Third Bank First Northern Credit Union Generations Credit Union MembersAlliance Credit Union Riverside Community Bank Rockford Bank and Trust Company Stillman Bank US Bank Any of the above
We can supply information to our clients through: (check all that apply)*

Publication or newsletter Electronic bulletin or e-mail list Mailings/paycheck stuffers Outreach event or community meeting
We would like to order the following materials:
English posters
Spanish posters
Trilingual coupons for mailings (English/Spanish/Polish)
Brochures (Spanish/English)
Referral Cards

Yes
Contact Information:
Name*
Title
Organization*
Phone (numbers only)*
Street*
City*
State*
Zip*
E-mail:*
Additional Comments
Enter code as shown*
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