Please complete this application by March 1, 2021 to be eligible.
* Indicates a required field. You may enter information manually, copy and paste information into the field box, or choose to upload documents at the bottom of this form. If you are selected as a recipient of the Citizen Volunteer Lakeview Bank Legacy Award, we will donate $1,500.00 in your honor, to up to three non-profit organizations of your choice.