Operation Roundup(Secure Form)


Your Information
Give a little. Help a lot. Your Operation Round Up contributions will be used right here in our service area to help pay energy bills as well as provide food, clothing, shelter, health care and other vital community services.
Type of Contribution:
Yes! Please round my bill up to the nearest dollar. Thank you for joining Operation Round Up.
OR
Please add the following amount to my "rounded up" bill each month as an additional contribution
     to Operation Round Up PLUS:
$
OR
Make a one-time donation to Operation Round Up.

Select payment method:*
Bank Draft Credit Card
Bank Draft
One Time Payment Amount:
$
Bank Name:
Bank Routing Number:*
Bank Account Number:*
Acct. Type:*
check
Credit Card
One Time Payment Amount:
$
Name on Credit Card:*
Credit Card Number:*
Card Type:*
Exp. Date:*
  Personal Information
First Name:*
Last Name:*
Email Address:*
Daytime Phone: *
- -
Cell Phone:
- -
Street Address:*
City:*
State:* Zip:*