AI Adoption Pilot Program Institution Name * Institution Type * Community Bank Credit Union Charter Number/NCUA ID * Total Assets ($) * Primary Contact Full Name * First Name Last Name Primary Contact Title * Primary Contact Email * Primary Contact Phone * (###) ### #### Institution Address * AI Exploration & Implementation Interests Primary Areas of Interest (check all that apply): Fraud Detection & Prevention Customer Service & Chatbots Credit Risk Assessment Loan Processing Automation Regulatory Compliance Monitoring Customer Analytics & Personalization Operational Efficiency Other (please specify) Top Priority Use Case Commitment to Program Requirements (check all that apply) Monthly progress reporting Knowledge sharing with peer institutions Post-pilot evaluation and case study development Additional Support Needed (check all that apply) Regulatory guidance Technical training Change management Vendor evaluation assistance Anything we didn’t ask but should know: Type Your Full Name I certify that the information provided is accurate and that our institution is committed to actively participating in this pilot program to advance AI adoption in community financial institutions. By typing your full name in the field below and clicking 'Submit,' you are providing your electronic signature. This typed signature carries the same legal weight as a handwritten signature. Date MM DD YYYY Thank you for your application. We will review your submission and be in touch within the next 24-48 business hours.
