Operation Round Up

Today's Date

Name of Organization

Address

Phone

Contact Person & Title

Has this organization ever applied for or received an Operation Round Up Grant?

If answered yes above, indicate most recent date grant was received and what project was funded.

Is the organization requesting funding except from payment of income tax? If yes, a copy of letter (Form 501(c)3) from Internal Revenue Service must be attached.

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Project Title

Project Start Date

Project End Date

Grant amount requested?

Upload completed Proposed Budget form provided above.

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What would this funding pay for?

Statement of project purpose.

Number of people in the community who will benefit from this project:

Geographic area to be served by project:

Is area served by a utility other than Iowa Lakes Electric Cooperative?

How will the project benefit the community or area?

Other revenue sources and/or demonstrated community support for the project:

If Operation Round Up were able to fund a portion of the amount requested, would the project be able to proceed?

What are the measurements of success for the project?

Will Iowa Lakes Electric Member Charitable Foundation be recognized for its support of this project?

Upload a copy of IRS 990 (pages 1 and 2 only) for previous year. Must be provided.

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Choose a file or drag and drop one here.

Submit Letters of Recommendation (1 of 3)

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Submit Letters of Recommendation (2 of 3)

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Submit Letters of Recommendation (3 of 3)

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By signing my name in the signature box below, I understand that the information contained in this statement is for the purpose of obtaining funding from Iowa Lakes Electric Members Charitable Foundation on behalf of the undersigned. I understand that the information provided herein is used in the decision to grant funding, and by signing I understand this represents and warrants that the information provided is true and correct until a written notice of change is provided. The Iowa Lakes Electric Members Charitable Foundation is authorized to make all inquiries deemed necessary to verify the accuracy of the statements made herein. As a condition receiving and accepting these grant funds, the undersigned agrees that all funds will be used for the project approved and as stated on the application. Any funds not used shall be returned to the Iowa Lakes Electric Members Charitable Foundation and as a grant from the Iowa Lakes Electric Members Charitable Foundation, this project should be completed and funds utilized within one year of this notification. I agree to the terms stated above.

I agree to the terms & conditions

Organization Name

Today's Date

Name of Organization

Address

Phone

Contact Person & Title

Has this organization ever applied for or received an Operation Round Up Grant?

If answered yes above, indicate most recent date grant was received and what project was funded.

Is the organization requesting funding except from payment of income tax? If yes, a copy of letter (Form 501(c)3) from Internal Revenue Service must be attached.

Upload your file

Choose a file or drag and drop one here.

Project Title

Project Start Date

Project End Date

Grant amount requested?

Upload completed Proposed Budget form provided above.

Upload your file

Choose a file or drag and drop one here.

What would this funding pay for?

Statement of project purpose.

Number of people in the community who will benefit from this project:

Geographic area to be served by project:

Is area served by a utility other than Iowa Lakes Electric Cooperative?

How will the project benefit the community or area?

Other revenue sources and/or demonstrated community support for the project:

If Operation Round Up were able to fund a portion of the amount requested, would the project be able to proceed?

What are the measurements of success for the project?

Will Iowa Lakes Electric Member Charitable Foundation be recognized for its support of this project?

Upload a copy of IRS 990 (pages 1 and 2 only) for previous year. Must be provided.

Upload your file

Choose a file or drag and drop one here.

Submit Letters of Recommendation (1 of 3)

Upload your file

Choose a file or drag and drop one here.

Submit Letters of Recommendation (2 of 3)

Upload your file

Choose a file or drag and drop one here.

Submit Letters of Recommendation (3 of 3)

Upload your file

Choose a file or drag and drop one here.

I agree to the terms & conditions

Organization Name

Today's Date