Operation RoundUp Application

Application for Operation RoundUp Grant

NOTE: If you have previously received a grant from February 2004 to the present, then you MUST submit an Operation Round-Up Activity Sheet detailing how you used the grant funds BEFORE you will be awarded any further grants from Roanoke Electric Care Trust, Inc.

All applications for 2023 second quarter grants should be submitted by 5 p.m. on March 31.

NOTE: Instructions for submitting additional information can be found at the bottom of this application.

Submit this form by clicking the “Submit Form” button at the bottom of the form. (Please DO NOT submit by printing and faxing this form. We can serve you more accurately and effectively if you submit the form electronically.)

Fields marked with a red asterisk * are required.

Step 1 of 3

Name Of Organization:*
Amount Requested:*
Provide a short summary of project/program you would like Round-Up to fund
Project Summary:*
Address:*
Street Address Address Line 2 City State ZIP Code
Phone Number:
Organization Contact Information
Contact Name:*
Contact Phone:*
Contact Email:*

If your organization has received an Operation Round-Up grant(s) previously, provide date(s) of grant(s)received:
Is the organization requesting funding exempt from payment of income tax?*
- Yes
- No
NOTE: If tax exempt, you must attach a copy of Form 501(c)3 letter or a letter indicating your non-profit status from the Internal Revenue Service. A copy of financial statements(s) from at least the previous two years must be provided. If your organization is less than two years old, you must provide the most recent financial statements. You must provide a copy of your program's income and expenditures. You MUST include these statements in order to be eligible. Do NOT send bank statements or income tax reports - these do not qualify as financial reports. Instructions for including additional documentation can be found at the bottom of this application. Provide the number of individuals, families, or groups that you estimate are served by your organization in Halifax, Northampton, Hertford, Bertie, Gates, Chowan or Perquimans counties in the last year.
Instructions for submitting additional documents:
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 Upload:
Max. file size: 220 MB.
County Information
Number Served:*
Does your agency serve outside the counties listed above?
- Yes
- No
Please provide information on number served and in which counties:
State the purpose/mission of this grant request:*
How much money are you requesting for this grant? Detail how the funds you have itemized in the Budgetary Items Form (below) will be used. Will you accept partial funding? If so, how will you find the rest of the money needed to make the project happen?*

Application for Operation RoundUp Grant

Step 1 of 3

Organization Contact Information

Instructions for submitting additional documents:

County Information

Budgetary Items