Sharing Success Program

Organization Name

Organization Tax ID Number

Address

City/Town

State/Province

ZIP/Postal Code

Contact Person

Contact Phone

Contact Email

BRIEF description of organization & community(ies) it impacts

Funding Amount Requested

Funding Use Timeline

Concise description of how funding will be used.

IRS 501(c)(3) Notice Letter.

Upload requirements

Optional: Upload files that showcase project

Upload requirements

The information contained in this application is for the purpose of obtaining funds from Menard Electric Cooperative. If approved for funding the applicant will receive an additional electronic application from CoBank to complete for a matched donation. Undersigned warrants the information provided is true and complete. MEC may make any inquiries deemed necessary to verify accuracy of statements made herein.

Signature

Date

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