Operation Round Up / Community Trust Application

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Grant Application for Organizations

Organization Information

Name of Organization(Required)

Date (mm/dd/yyyy)(Required)

Address

Street Address City State ZIP Code

Contact Person(Required)

Phone(Required)

Email

Is Organization(Required)

For Profit
Non-Profit
501c3 if non-profit

Organizational History/Purpose(Required)

Organizational Programs and Results(Required)

Number of individuals, families or groups served annually(Required)

Geographic Area Served(Required)

Does organization utilize volunteers?(Required)

Yes
No

Explain:

Grant Request

from Community Trust(Required)

In USD dollars ($)

For Total Project(Required)

In USD dollars ($)

Describe the project:(Required)

When is funding needed?

Other funding sources and their contributions

Attach a copy of financial statements for 3 years (prior year's actual, current year's estimate and next year's budget)(Required)

Max. file size: 100 MB.

Financial statement (2)

Max. file size: 100 MB.

Financial statement (3)

Max. file size: 100 MB.

Statement attached(Required)

The information contained in this application is for the purpose of obtaining funding from the Mille Lacs Energy Community Trust on behalf of the undersigned. We understand that the information is confidential, for the Trustees review only. The information provided is true and complete.

Name of Organization(Required)

Member Consent(Required)

I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.

Member Electronic Signature (Full Name)(Required)

The Trust Board meets quarterly. Applications may be submitted at any time and will be presented for review at the next board meeting. Each organization is allowed only 1 donation per year.