Operation Round-Up Grant Application

Please complete this application by providing the requested information below. Attach any supporting documents, which may include organizational information, project documents, pictures, bids, cost estimates, or fundraising information. (Take a picture/screenshot of documents or scan to attach.)

Recurring deadlines are May 1st and November 1st. The board of trustees awards grants approximately one month after the deadine. Call the office with any questions at 605-996-7516. Applicants may review Central Electric's Operation Round-Up Grant Guidelines to learn more and help determine if a project is eligible for funding.

Name of Organization

Address of Organization

Street Address

PO Box / Mailing Address (If Different from Street Address)

CityState

Zip Code

Representative Name

First NameLast Name

Representative Title

Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Contact Email

example@example.com

Project funding category. You may choose more than one if applicable.

Primary county that will benefit from the project.

Amount of Grant Request (up to $3,000)

Total Project Cost

Describe the project and how potential grant funds would be used. Explain how the project will benefit the community and area residents. Projects that will be completed within 12 months are given highest priority.

About the Project

File Upload: Please attach any supporting documents. This may include organizational information, pictures, documents, blueprints, bids, cost estimates, or fundraising information. If you include financial documents, please remove any account numbers.

Has the organization received an Operation Round-Up grant from Central Electric Cooperative in the past?

To the best of your knowledge, how many individuals does the organization serve within Central Electric Cooperative's service area?

Who the Project Serves

Please list other funding sources being considered for the project. This may include private donations, fundraisers, existing funds, or other organizations. Click "Add New" to list more than one source.

Optional: Please provide 1-2 local business references that are familiar with the project. By listing a reference, you are granting permission to contact them about the project. Click "Add Row" to list more than one reference.

The information contained in this statement is for the purpose of obtaining funding from Central Electric Cooperative, Inc.’s Operation Round-Up® Fund. The undersigned understands that the information provided herein is used in deciding grant funding, and the undersigned represents and warrants that the information provided is true and complete and that Central Electric Cooperative, Inc. may consider this statement as continuing to be true and correct until a written notice of a change is provided.

Central Electric Cooperative and the Board of Trustees for Operation Round Up® are authorized to make all inquiries deemed necessary to verify the accuracy of the statements made herein.

As a condition of receiving and accepting 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 Central Electric Cooperative Operation Round Up® Fund.

I agree to the terms stated above.

Representative Name

Representative Title

Signature of Representative

Date