Agency Participation

Dollar Energy Fund, Inc.
iPartner^© 2010 - Dollar Energy Fund
Agency Participation Form & Agreement

Introduction

Step 1 -
Current or New Organization

Step 2 -
Profile Information

Step 3 -
Terms & Conditions

Step 4 -
Membership Option

Step 5 -
Training Registration

Step 6 -
Confirmation

Thank you for your interest in the Dollar Energy Fund Grant Program. During this participation process, you will be asked to provide information about the following areas:

Organization information
This information is used for reimbursement purposes.
Agency site information
This information pertains to the individual walk-in locations for customers completing a grant application. Each organization can have multiple agency sites.

The agency site information is then broken down into several sections. They include information about:

Each site's primary contact
Location Address (not mailing address)
Option to not include the address on our agency finder
Service territory
Provided services

Please complete the following information no later than September 24, 2010.

Note: Completing this form does not guarantee you will become a Grant Program Screening Agency. All agencies must successfully complete the Dollar Energy Fund Grant Program Training and Certification Program before becoming an official Dollar Energy Fund Grant Program Screening Agency.