REPORT OUTAGE: 800-776-0493

Apply for an Operation Round Up Grant

Operation Round Up Organization Application

Operation Round Up Organization Application

Organization Information

(as it should appear on the check, if grant awarded, if different than above)
Address
Address

Organization Financial Information

Is organization requesting funding exempt from payment of income tax?
Maximum upload size: 33.55MB
Maximum upload size: 33.55MB
Please note we are interested in the general publicly disclosed statements, not your detailed information.

Contact Information

Name
Name

Nature of Request

More About Your Organization

Do you have a Board of Directors?
(As a dollar and/or percent of total operating expense)

Contingency Plan

References

Please list three references: (may not be an employee or director of the Whitewater Valley REMC or a trustee of the Whitewater Valley REMC Community Trust, Inc.)

The information contained in this statement is for the purpose of obtaining funding from the Whitewater Valley REMC Community Trust, Inc. 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 Whitewater Valley REMC Community Fund, Inc. may consider this statement as continuing to be true and correct until a written notice of a change is provided. The Whitewater
Valley REMC Community Fund, Inc. is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.

I understand in applying for funding that if granted, it will be used for the sole purpose as stated in this application.

Further, I understand that if funding is received, I grant permission for its publication in the Whitewater Valley REMC’s monthly publication as well as any other publication the Whitewater Valley REMC deems appropriate.

Whitewater Valley REMC Logo

Mailing Address

P.O. Box 349
Liberty, IN 47353


Business Hours

7:30 a.m. - 4:30 p.m.
Monday through Friday


Phone Numbers

765-458-5171 and
800-529-5557

© Whitewater Valley REMC. All Rights Reserved.