Donation Request Form

Eastern Iowa Light and Power Cooperative supports Cooperative Principle, Concern for Community, through donations made to community focused organizations. To request a donation from the Cooperative, please submit this Donation Request Form.

Organization Name & Address

Name of Organization

Street Address

City

State

Zip Code

501(c)(3) EIN (if applicable)

Mailing Address (if different than above)

Address

City

State

Zip Code

Contact Information

Contact Person

Phone Number

Email Address

Additional Information About Your Request:

· Please describe your request:

· What type of donation are you requesting?

CheckAuction Item

If a check is being requested, who should the check be written to and where should it be mailed?

Check should be written to:

Check should be mailed to:

Will the Cooperative be recognized for the donation?

Yes

If you selected 'Yes', what methods of recognition will be used?

· Has your organization received a donation from the Cooperative in the past?

Yes

Upload Documents

· Please upload supporting documentation for your request. Examples include: fundraiser flyers, sponsorship forms, organization brochures, etc.

Submitting this Donation Request Form does not guarantee a donation will be made from Eastern Iowa Light & Power Cooperative. Requests will be evaluated, and your organization will be notified if your request has been approved.

Contact Information