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Donation for Organization Application
Name of Organization:
Address:
Address
Address 2
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State/Province
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Armed Forces Americas
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ZIP/Postal Code
Phone Number:
Contact Person:
Is organization requesting funding exempt from payment of income tax: if yes, a copy of letter (Form 501[c]3) from the Internal Revenue Service must be attached.
yes
no
Number of individuals, families or groups your organization/agency served in West River Electric Association's service are in the past year:
Please attach a copy of the financial statement(s) for the most previous year.
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Upload requirements
One file only.
20 MB limit.
Allowed types:
txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods
.
State purpose of Organization/Agency Request: (include amount requested and specifics on how funds will be used-operation or specific need-dade needed.)
List other sources of funding for use of request as described in the above:
What are the benefits to the citizens of this area?
***Pictures of what you are doing or planning may also help in the decision making.
Upload
Upload requirements
One file only.
20 MB limit.
Allowed types:
txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods
.
Please list three references
First
Last
Phone Number:
Please list three references
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Relationship to Organization
Reference 2
First
Last
Phone Number:
Please list three references
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Relationship to Organization
Reference 3
First
Last
Phone Number:
Please list three references
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Relationship to Organization
List Board Members:
If requested, would a representative be available to attend the board meeting?
Yes
No
Name
First
Last
Phone:
Relationship to Organization
The information contained in this statement is for the purpose of obtaining funding from the West River Electric Charitable Trust on behalf of the undersigned. Each undersigned understands that the information provided herein is used in deciding to grant funding, and each undersigned represents and warrants that the information provided is true and complete and that the West River Electric Charitable Trust may consider this statement as continuing to be true and correct until a written notice of a change is provided. The West River Electric Charitable Trust is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.
Name of Organization:
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Your Coop
Board of Directors
Service Area
Construction Handbook and Updates
Contact Us
Solar and Wind Energy
My Account
Capital Credits 101
New Member Page
Payment Options
Financial Assistance Resources
Phone and Email Scams
Sign Up for Service
SmartHub Help
Membership
Scholarships
Credit When Credit Is Due
Call Before You Dig
Demand Response Program
Marathon Water Heaters
Operation Roundup
Together We Save
Generator Safety
CO-OP CONNECTIONS SAVINGS
Air-Source Heat Pumps
Electric Vehicles
Energy Audits
Peak Times
Credit When Credit Is Due
Outages and Safety
Power Outages
Safety Quiz
Powerline Safety
Connections
2022 Connections
2021 Connections
2020 Connections
2023 Connections
2024 Connections
Rate Adjustment Coming April 2024