Operation Round Up | Tri-County Electric Cooperative

Safely powering our communities with innovation, accountability and integrity - every member, every time.

Contact Name

Organization Name

Phone

Address

Address 2

City/Town

State

ZIP

Federal I.D. Number (EIN)

Organization Purpose

Briefly describe your organization's purpose for someone who may not be familiar with it.

Project

Briefly describe your program or project that requires funding. This is often used as the check's memo line.

Start Date

End Date

Describe how your organization will use any funds received.

Please be specific. Include how your project meets the Foundation's guidelines of disbursing funds for charitable, educational or emergency services purposes.

Describe other sources of funding.

How is your organization funded? What other places have you applied to for funding of this program or project?

Attach any supporting materials that may be helpful.

Maximum 10 files.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Examples: material or project quotes, itemized breakdown of how the funds will be used, project images, or any other items you may have.

Additional comments or notes

Funds Requested

Limited to $5,000 or less per year unless an exception is approved by the Foundation Board.

Check Needed By

Population Served

Enter the number of people served by your organization or project.

Area Served

Is organization 501c3 exempt?

Is organization an educational institution or municipal entity?

Is organization affiliated with religious organization?

Final report provided by

A final report with photos, videos, receipts or statements showing the use of the funds is required. When will you provide this report?

I understand funds are not to be used for political activities or utility bills.

The information contained in this application is for the purpose of obtaining funding from the TCEC Foundation on behalf of the undersigned. The undersigned understands that the information provided herein is used in deciding to disburse funding and the undersigned represents and warrants that the information provided is true and complete and that TCEC Foundation may consider this application as continuing to be true and correct until a written notice of a change is provided. The TCEC Foundation is authorized to make all inquires they deem necessary to verify the accuracy of the statements made herein. It is understood that all information herein will be kept in the strictest of confidence by the TCEC Foundation Board of Directors. Type your name to indicate your agreement with this statement.

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580-652-2418 Hooker, OK

580-652-2418
Hooker, OK