Operation RoundUp Activity Sheet

NOTE: No further grants will be administered to any organization receiving grants until the activity sheet for the project is submitted to Roanoke Electric Care Trust, Inc.

Fields marked with a red asterisk * are required.

Organization Profile
Name Of Organization:*
Contact Name:*
Contact E-mail Address:*
Please list Names, phone numbers, and email addresses of other Team Members:
Project Information
Month/Year that you were granted Operation RoundUp funds for this particular project:*
Amount Granted:*
Activity County/Counties:*
Target Group of Project:*
Number Of People Impacted:*
Is your project sustainable and able to be duplicated?*
- Yes
- No
If sustainable, give detail:
Is this a new activity?
- Yes
- No
If not a new activity, how many years has the activity or project been in existence?
Did you purchase equipment or fund the activity that you were granted monies for? Why was this project important or beneficial? Please submit copies of receipts and pictures of the equipment purchased or proof of the activity you were granted funds for. (Instructions for submitting documents are included at the end of this application.)
Activity Summary:*
Why is there or was there a need for the activity that was funded by the grant? Are there similar activities being implemented in the service area? If yes, what new solutions did your activity bring to the service area?
Activity Need:*
If applicable, describe the partnerships with other agencies that were created through the project funded by Operation RoundUp:
Agency Parthernships:
Describe, in your own words, the role of a program like Operation RoundUp in your region. Why does this area need programs like RoundUp?
RoundUp Role:*
Submitting Additional Documentation
There are four methods available for submitting additional documentation.
Method 1: Postal Mail
Mail copies of pictures and paper documents to the address below.
Patrice Jordan - Supervisor, Public Relations & Engagement
Roanoke Electric Cooperative
P.O. Box 1326
Ahoskie, NC 27910
NOTE: If you send additional information by mail, do not bind, use staples, or put your documents in a portfolio. Use only paper clips to hold information together.
Method 2: E-Mail
After submitting this online application, you will receive a confirmation email. By replying to this email you can submit electronic copies of scanned images and PDFs by attaching them. Use the personalized subject provided to ensure your documents get delivered to the right place.
Method 3: Fax
Fax copies of pictures and paper documents to the fax number below.
Method 4: Electronic File Upload
You can submit electronic copies of images or PDF documents with the file attachment tool below. If you have multiple files, you can combine your electronic documents into one zip file (using your zip software) and attach the zip file to this application.
File
Max. file size: 220 MB.
Chief Officers Signature:*
Date:*

Day
Month
Year

Organization Profile

Project Information

Submitting Additional Documentation