Sharing Success Application | Lea County Electric

LCEC & COBANK’S “SHARING SUCCESS” MATCHING GRANT PROGRAM APPLICATION FORM

Once completed, please return to Celeste Holt or Rosie Insilan at Lea County Electric Cooperative, Inc. via USPS: PO Drawer 1447, Lovington, NM 88260, E-Mail: rinsilan@lcecnet.com, or in person at any of our three offices. Applications with required documentation must be received by end of business day on Friday, June 2nd, 2023.

Please contact Rosie Insilan directly with any questions by calling 575-396-9620.

Nonprofit Organization Name

Address

City/Town

State/Province

ZIP/Postal Code

TIN (Taxpayer Identification Number)

Contact Name

Contact Title

Contact Phone Number

Intended use of gift (Please provide a brief description of the organization, program, and intended use of the contribution. You may attach documents if necessary.)

Proof of the nonprofit organization’s 501(c)(3) status must be provided with this application. Select organizations that are not designated a 501(c)(3) are also eligible. These organizations include schools and government organizations such as counties or municipalities and their agencies or departments, as long as the donation serves a public purpose and is consistent with the purpose and guidelines of the Sharing Success program. If the recipient is not a 501(c)(3), please submit the organization’s TIN (taxpayer identification number). Matching funds are contingent upon availability of funds from CoBank.

Applicant’s Signature

Sign above

Date

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