Keystone Cooperative Propane with Purpose School Application

Keystone Cooperative Propane with Purpose School Application
Keystone is working to strengthen food security within our communities by alleviating school lunch debts in rural areas. Keystone will contribute $0.50 per propane delivery stop toward reducing school lunch debt in local schools, supporting families in need.
NOTE: In order to complete this form, you must have the following information:
An electronic copy of the school's W9
How many students are currently enrolled in this school?
How many students are currently on free/reduced lunches?
What is the average total dollar amount of unpaid lunch balances in a typical year
YesNoOther
What Location? *
YesNo
What location do you do business with? *
Customer Name:*

First NameLast Name
Customer Email:*
example@example.com
Customer Phone Number: *
Please enter a valid phone number.Format: (000) 000-0000.
Employee Contact:*

First NameLast Name
Employee Phone:*
Please enter a valid phone number.Format: (000) 000-0000.
Employee Email:*
example@example.com
School Name:*
School Address:*

Street Address

Street Address Line 2

CityState

Zip Code
School Contact:*

First NameLast Name
School Phone:*
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email:*
example@example.com
Copy of W9:*

Cancelof
Tax ID #:*
In what county does your school operate:*
How many students are currently enrolled in this school:*
How many students are currently on free/reduced lunches:*
What is the average total dollar amount of unpaid lunch balances in a typical year:*
Is there anything else you want to tell us about your school?
Should be Empty: