Application for FreeState Donation Dollars

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PURPOSE

FreeState Electric Cooperative is happy to support local schools and organizations with local community events and school programs and projects.

In 2024, the cooperative launched "Donation Dollars" which is a program that provides local sponsorships and donations to organizations, programs, and projects that meet the mission, vision, and values of the cooperative.

Applications must be submitted via this digital form. Paper forms will not be accepted.

RESTRICTIONS

Donations will not normally exceed $500.

EVALUATION FACTORS

The following factors will be considered in the evaluation of Donation Dollar requests:

Potential benefit to area residents and the entire community.
Level of community support for the program or project.
Level of impact for FreeState members.
Geographical location and impact.
Results are predictable and can be evaluated.

Contributions will not be made for:

Individuals or events specific to an individual.
Lobbying, political organizations, or highly sensitive/controversial events.
Fraternal and labor organizations
Capital fund campaigns.
National fund drives.
Ongoing operational expenses.
Private organizations, or events that are exclusive.

The cooperative evaluates applications on the alignment of the cooperative's mission, vision, and values. Donation Dollars are subject to board approval.

I understand that the information I provide in this application will be used by the cooperative to determine eligibility of Donation Dollars for my organization.

I understand

Eligibility Verification

Does your organization operate in the FreeState service territory?

YesNoI don't know.

Is your organization associated with a school district in the FreeState territory?

YesNoI don't know

Is your organization associated with any of the following?

K-12 Education of Member School USD 330
K-12 Education of Member School USD 437
K-12 Education of an area school
Community Event Sponsorship
City recreation or other youth sport or activity
Food Pantry or Organization providing resources

Is your organization associated with any of the above?

YesNoI don't know

If you answered "yes" to these questions, please proceed to the next page.

If you answered "no" or "I don't know" to any of these questions, you may not be eligible for local donation dollars. You can proceed, but please be aware of your eligibility.

Why are these questions asked? FreeState understands the need to spend member dollars as responsibly as possible. We want to take the time needed to evaluate each request to make certain it aligns with the mission, vision, and core values of the cooperative.

By gathering the correct information up front, we can be as efficient as possible.

Organization Contact Information

Please note that you should provide an address where your organization receives mail. If your mail is not checked regularly, please provide a mailing address that can be used for correspondence. While most correspondence is done via email, checks are typically sent through the USPS.

Please provide a working email that is monitored and phone number where someone can be contacted. Failure to provide accurate information could mean your organization may not be considered.

Organization Name

First Name

Last Name

name@domain.com

Mailing Address

Zip Code

If funding is granted, who should the check be made payable to?

Organization Website (if applicable)

About Your Organization

Please provide us with a brief overview of your organization. You should not exceed 750 words.

Tell us about the organziation

What geographical area does your organization reach?

Does your program, project, or organization directly impact FreeState members?

YesNoA Hybrid (yes and no)I'm Not Sure

Funding Request

How much funding are you requesting?

Project, Program or Other Details

In this section, tell us more about how you meet community needs.

This is information about the specific project you would like the funding for. Be as specific as possible and please provide information that is relevant to your ask.

If you provide direct assistance, please provide a general idea of the demographics and statistics about that assistance. If a project is targeted to a specific group of people, please provide that information.

There will be a place at the end of the application to upload information. If you are uploading information, please note that in the box provided.

Please describe the project or program you are seeking funding for. Text limit is 1,000 words.

Describe how this project or program contributes to the mission of your organization. Text limit is 1,000 words.

Describe the expected results from the project. Text limit is 1,000 words.

Need to provide more information?

Additional Uploads

If you have any other information to add to your application, please upload it below. If you do not have any other information to upload, please proceed to the next page.

Is there anything else you would like the let the cooperative know about, or include in your application?

Additional Information

You're almost ready to submit your application!

Signature and Submit

The information I have provided is true to the best of my knowledge and I understand that any misrepresentation of information on this form may be grounds for denial of donation dollars. I also understand that my application does not entitle me to immediate funding and my organization may be denied for any reason. I also understand this process could take up to 5 business days for review.

I understand

By typing my name into this box I agree that this represents my signature and give FreeState Electric Cooperative permission to utilize my information to initiate my organizations application process.

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