Skip to main content
MAIN MENU
Home
Your Cooperative
Your Electric Service
Payment Options
Billing Options
Billing Fees & Info
Rate Schedules
Powerlines Newsletter
Safety & Outage Info
Capital Credits
Products & Services
Rebate Programs
Tree Trimming
Energy Audit Services
Outdoor Lights
Electric Vehicles
Community
Annual Meeting
Youth Programs
Co-op Connections Savings
Operation Round Up
Donations and Sponsorships
Career Opportunities
Forms
About Us
History
Contact Us
New Facility
District Map
Board of Directors
Cooperative Principles
Touchstone Energy Cooperatives
CONTACT INFORMATION
Parke County REMC
119 W. High St.
Rockville, IN 47872
(765) 569-3133
(800) 537-3913
119 W. HIGH ST., ROCKVILLE, IN 47872
(765) 569-3133
|
(800) 537-3913
Search
You must have JavaScript enabled to use this form.
Sponsorship Request ($250 Max)
Please complete this form for sponsorship requests. We will review the requests on the third Wednesday of every month. *For larger sponsorship requests, please complete the Operation Round Up Grant request application. For questions, please call the office at 765.569.3133
Are you applying for a sponsorship for a non-profit organization?
Yes
No
Non-Profit
Non-Profit Organization Information
Non-Profit Organization Name
Address
Address 2
City/Town
State/Province
- None -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Contact Information
Contact First Name
Contact Last Name
Contact Title
Contact Email Address
Contact Cell Phone Number
Contact Work Phone Number
Have you received a sponsorship from Parke County REMC in the past?
Yes
No
Requested Sponsorship Amount
Total Sponsorship Goal
Title of Project/Program
What is the total number of people who will benefit from the overall potential impact of the sponsorship? Please provide an explanation, if possible.
Please describe your project in detail, including what the sponsorship money will be used for.
Signature
Sign above
Date of Signature
Authorization
I am authorizing, to the best of my knowledge, the information stated above on this sponsorship application is true and correct.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Math question
14 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.