Account Services

Round Up Application

The Energy Cooperative Round Up Foundation, Inc.
1500 Granville Road
P.O. Box 4970
Newark, OH 43058-4970
(Not to exceed $10,000 annually)
If yes, a copy of the organization’s I.R.C. Section 501(c) (3) determination letter from the Internal Revenue Service or evidence of the organization’s status or a governmental entity must be attached and included with this application.
A copy of financial statement(s) (Form 990 or an audit) for most recent year must be attached to this application.
Number of individuals, families, or groups served in each of these counties last year:
Please list three references:
The information contained in this statement is for the purpose of obtaining funding from The Energy Cooperative Round Up Foundation, Inc. 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 that the information provided is true and complete and that The Energy Cooperative Round Up Foundation, Inc. may consider this statement as continuing to be true and correct until a written notice of a change is provided. The Energy Cooperative Round Up Foundation, Inc. is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.
Please note that for the organization or agency who receives funding:
1) The Energy Cooperative Round Up Foundation, Inc. publishes the name, amount, and purpose of funding granted. You may also be asked for a photograph for public relations purposes.
2) We also ask that you provide the Foundation with information to substantiate the use of funds awarded, such as copies of invoices, pictures of equipment purchased, or a statement describing specifically how the funds were used.
Attention Applicants: A copy of your organization’s I.R.C. Section 501 (c) (3) determination letters from the Internal Revenue Service or evidence of the organization’s status or a governmental entity must be provided. All applications without supporting documentation will be considered incomplete.
UPSP: Operation Round Up Foundation, P.O. Box 4970, Newark, Ohio 43058-4970, Attn Margy Klein
Fax: 740-344-2054 Attn: Margy Klein
Email: mklein@theenergycoop.com