Donation Request (Under $100)
Please complete this form for all donation requests that are under $100. We will review the requests on the third Wednesday of every month.
Are you applying for a donation for a non-profit organization?
Non-Profit Organization Information
Contact Information
Have you received a donation from Parke County REMC in the past?
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I am authorizing, to the best of my knowledge, the information stated above on this donation application is true and correct.
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Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.