Clarke Electric participates in a renewable energy program that allows members the opportunity to voluntarily contribute to the development of alternate energy production in Iowa

If you would like to contribute to this fund, print and fill out the form and send it to:

Clarke Electric Cooperative
PO Box 161
Osceola, Iowa 50213

Or fax it to: 641-342-6292

Renewable Energy Contribution Fund
	Yes, I will make a one time contribution
	Yes, I will contribute $__________ per month
Name: _______________________________________________
Account No.__________________________________________
Address:_____________________________________________
City:________________________ State:______ Zip:__________