Operation Round-Up® Organization Application

The mission of the Comanche Electric Cooperative Operation Round-Up Program is the accumulation and disbursement of funds for approved organizations and individuals located within the CECA service territory.

Please fill out this application in full. Attach any supporting documentation or additional pages as needed.

Unanswered questions could result in application being refused due to incomplete application process.

Name of Organization requesting funding *

Address (Street or PO Box) *

City, State, Zip *

Work or Mobile Phone

Is organization a member of CECA? *

Yes

If yes, account number

Contact Person

Name and Title *

Daytime Phone *

E-mail Address *

State the purpose for the Organization/Agency request: Include specifics of how funds will be used. *

List other sources of funding for use of grant request as described above: *

If your organization has previously received an Operation Round-Up grant, provide the following information:

Amount Received

How were the funds spent?

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

Yes

What are the benefits to the community or area? *

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

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

What are your measurements for success for this project?

Donation requested: *

Electronic Signature

The information contained in this application is for the purpose of obtaining funding from Comanche Electric Cooperative Trust, Operation Round-Up, on behalf of the undersigned. Each undersigned understands that the information provided herein is used in deciding grant funding, and the undersigned grants and warrants that the information provided is true and complete and that the Comanche Electric Cooperative Trust may consider this statement as continuing to be true and correct until a written notice of a change is provided. The Comanche Electric Cooperative Trust is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.

Signature 1 *

Signature 2

Confirmation *

I understand that checking this box constitutes a legal signature confirming that I am the applicant listed on the application. I agree to allow CECA to use this organization’s name and photo in local and area publications to inform CECA membership of the activities of the Operation Round-Up Program.

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