Charitable Giving and Corporate Support Application

Charitable Giving and Corporate Support Application

Name of Organization Requesting Donation: *

Contact Person: *

Address: *

City: *

State: *

Zip Code: *

Phone Number: *

E-mail: *

Please indicate which tax exemption status applies to your organization: *

501(c)(3) - Nonprofit Organization

501(c)(4) - Social Welfare Organization

501(c)(6) - Business League

Organization's Tax Identification Number: *

Amount of Donation Organization is Requesting: *

Date Donation is Needed: *

Month

Day

Year

Has STEC donated to your organization before? *

Yes

If so, when and what dollar amount:

What Electric Cooperative does your organization belong to?: *

Please explain, in as much detail as possible, how these donation funds will be used for your organization (please attach additional information, if needed): *

Please use the browse button to select your 501(c) file for upload. If you have any other documents please combine them with your 501(c) into one file. The resulting file must be less that 4MB in size. The file must be in either PDF, JPG, or PNG format.

File Upload *

Please sign and date this form if you print it and fax or mail it instead of submitting it electronically.

_____________________________________
Signature

______________________________________
Date

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Charitable Giving and Corporate Support Application