Midwest Energy

Community Fund Application and Funding Report

Date: 

*Organization/Payee: 

*Street/PO BOX: 

*City:  *State:   *Zip: 

*Contact Person: 

E-mail Address: 

*Telephone:   Alt. Telephone: 

*Amount of Request: $

When will the funds be used: 

Number of people Benefiting from project: 

*Geographical area served: 

Project Summary:

*Brief description of organization:
(Limit 500 characters)


*What will be purchased? How will the funds be used?:
(Limit 500 characters)


*Description of how project or event benefits the community:
(Limit 500 characters)

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By submitting this application, I certify the information provided is true and complete.
*Name:       Title: 

If you have problems submitting the form, please contact Kay at 800-222-3121, EXT 1474.

Midwest Energy is a customer-owned electric and natural gas utility located in central and western Kansas.
We serve 48,000 electric and 42,000 natural gas customers.
© 2008 Midwest Energy, Inc. 1330 Canterbury Hays, Kansas 67601 800-222-3121
Comments or questions about the Web site? Please contact the Web Master.

May 17, 2008 10:44 am