Skip to main content
Home
About Us
About Mountain Parks Electric
Articles of Incorporation
Board of Directors
Board Meetings
Board Bulletin
Bylaws
Director Elections
Employment Opportunities
IRS Form 990
Public Board Policies
Rates & Tariffs
Electric Rates
Tariff
General Info & Stats
Community
Community Support
Scholarships & Youth Programs
Donation Request
Operation Round Up
Event Sponsorship
Information & Programs
Colorado Country Life Magazine
Electric Vehicles
Local Weather Data
New Construction
Online Survey
Pilot Programs
Prepaid Metering (EZ PAY)
Rates & Tariff
Contests
Events
Interconnection Procedures
Reserve MPE's Community Room
Account Services
Billing & Energy Assistance
Capital Credits
EZ Pay (Prepaid Metering)
FAQs
Higher Than Expected Electric Bill?
SmartHub
New Construction
One-Time Payment
Online Survey
Pay My Bill
Electric Service Application
Understanding Your Bill
Rebates & Renewables
Renewable Energy Portfolio
Clean Power Program & Net Metering
Clean Power Program Contribution Form
Clean Power Program Rebate Application
Clean Power Grant
Clean Power Program History & Stats
Rebates
Safety
Contact Us
My Account
Report an Outage
MPE Solar
Outage Map
Search
Home
About Us
About Mountain Parks Electric
Articles of Incorporation
Board of Directors
Board Meetings
Board Bulletin
Bylaws
Director Elections
Employment Opportunities
IRS Form 990
Public Board Policies
Rates & Tariffs
Electric Rates
Tariff
General Info & Stats
Community
Community Support
Scholarships & Youth Programs
Donation Request
Operation Round Up
Event Sponsorship
Information & Programs
Colorado Country Life Magazine
Electric Vehicles
Local Weather Data
New Construction
Online Survey
Pilot Programs
Prepaid Metering (EZ PAY)
Rates & Tariff
Contests
Events
Interconnection Procedures
Reserve MPE's Community Room
Account Services
Billing & Energy Assistance
Capital Credits
EZ Pay (Prepaid Metering)
FAQs
Higher Than Expected Electric Bill?
SmartHub
New Construction
One-Time Payment
Online Survey
Pay My Bill
Electric Service Application
Understanding Your Bill
Rebates & Renewables
Renewable Energy Portfolio
Clean Power Program & Net Metering
Clean Power Program Contribution Form
Clean Power Program Rebate Application
Clean Power Grant
Clean Power Program History & Stats
Rebates
Safety
Contact Us
Operation Round Up Assistance Application for an Organization or Charity
Name of organization:
Name and title of contact person:
Organization Phone:
Contact phone:
Physical Address
Physical Address
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Mailing Address
Mailing Address
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
1. Is this organization requesting funding exempt from payment of income tax?
If yes, please attach a copy of your Form 501 (c) 3 letter from the Internal Revenue Service.
One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
What is the amount your organization is requesting?
What is the reason for your request?
2. Please attach a copy of financial statement(s) for the agency for the previous year.
One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
3. List any other grants that you have received during the last year.
4. How many individuals, families or groups were served by your agency last year?
5. What area does your agency serve?
6. Please state the purpose of your Organization/Agency request. Include the total amount requested, specify how the funds will be used, and include proposed plans and estimate.
7. List other sources of funding for purpose of the request above:
8. If applicable, how do you measure effectiveness?
9. Please list three references.
Reference #1
Name
Email
Phone
Address
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Reference #2
Name
Email
Phone
Address
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Reference #3
Name
Email
Phone
Address
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
The information contained in this statement is for the purpose of obtaining funding from the Mountain Parks Electric Charitable Trust 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 the information provided is true and complete and that the Mountain Parks Electric Charitable Trust may consider this statement as continuing to be true and correct until a written notice of change is provided. The Mountain Parks Electric Charitable Trust is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.
Organization name:
Have you requested or received any other MPE funding for this program/event/initiative? If yes, please explain.
Web Signature of Representative
Sign above
Date:
I, (Fill in the blank) allow my/my organization’s photo and/or name to appear in Mountain Parks Electric’s publications to promote the Mountain Parks Electric Charitable Trust.
I will
Check here if you will allow my/my organization’s photo and/or name to appear in Mountain Parks Electric’s publications to promote the Mountain Parks Electric Charitable Trust.
I will not
Check here if you will not allow my/my organization’s photo and/or name to appear in Mountain Parks Electric’s publications to promote the Mountain Parks Electric Charitable Trust.