Beartooth Electric Members Helping Members Application

Beartooth Electric Members Helping Members, Inc. (MHM) is a charitable fund whose funding is limited. As a result, the Board is forced to limit the amount of benefit awarded and prioritize the list of applicants based on the application information provided. Please describe any special circumstances or conditions that you would like the MHM Board to be aware of as they determine your eligibility for assistance (Please submit an additional page if necessary).

The information in this application is to obtain funding from MHM on behalf of the undersigned. The applicant understands that the information provided here is used to decide grant funding. The applicant represents and warrants that the information provided is true and complete. MHM is authorized to make all inquiries necessary to verify the accuracy of the statements made in this application. By signing this application, authorization is granted for providers contacted by MHM to supply the information requested to verify this application.