Skip to main content
Search
Select Language
English
Afrikaans
Albanian
Arabic
Armenian
Azerbaijani
Basque
Belarusian
Bengali
Bosnian
Bulgarian
Catalan
Cebuano
Chinese (Simplified)
Chinese (Traditional)
Croatian
Czech
Danish
Dutch
Esperanto
Estonian
Filipino
Finnish
French
Galician
Georgian
German
Greek
Gujarati
Haitian Creole
Hausa
Hebrew
Hindi
Hmong
Hungarian
Icelandic
Igbo
Indonesian
Irish
Italian
Japanese
Javanese
Kannada
Khmer
Korean
Lao
Latin
Latvian
Lithuanian
Macedonian
Malay
Maltese
Maori
Marathi
Mongolian
Nepali
Norwegian
Persian
Polish
Portuguese
Punjabi
Romanian
Russian
Serbian
Slovak
Slovenian
Somali
Spanish
Swahili
Swedish
Tamil
Telugu
Thai
Turkish
Ukrainian
Urdu
Vietnamese
Welsh
Yiddish
Yoruba
Zulu
Outages
New Service
Contact Us
My Account/SmartHub
About Us
Board Nominations & Election
Capital Credits
Career Opportunities
Contact Us
Executive Team
Leadership
Our Story
Pay Your Bill
Services
New Service
Rates & Fees
Load Management
PrePaid Electricity
Distributed Generation
Renewables
Solar by Medina EC
Generators
Joint Use
Community
Community Empowerment Program
Donations and Sponsorships
Operation Round Up
Presentations & Programs
Rural Friends/ACRE
Scholarships
VFD Truck Giveaway
Youth Tour
Common Resources
Avian Protection Plan
Co-op Connections
Energy Savings
Rebates
SmartHub Resources
Texas Co-op Power
Vegetation Management
Work Locations and Updates
Life Support Registry
Products
Latest
Use SmartHub to manage your electric account.
Increase in attempted phone scams reported. Do not pay if someone calls demanding immediate payment.
1 of 2
VFD Vehicle Donation
Applicant Information
VFD Information
VFD Information
Legal Name of Organization
Doing Business As
if applicable
Email
Phone
Physical Address
Mailing Address
City/Town
State
ZIP
Website
Contact Information
Applicant Contact Information
Name
Position
Email
Phone
Organization Information
Approximately how many people are served?
Year Founded
Counties Served
Atascosa
Brooks
Dimmitt
Duval
Edwards
Frio
Jim Hogg
Kinney
LaSalle
McMullen
Medina
Real
Starr
Uvalde
Webb
Zapata
Zavala
Other Counties
Other Counties
Number of Volunteers
Paid Full-Time Positions
Paid Part-Time Positions
Organization check
Check here if you are a 501(c)
Check here if you're required to submit a form 990
Check here if you're part of an Emergency Services District
If you're a 501(c), please provide your Employer Identification Number (EIN)
If a 990 is required, please upload your latest copy here.
One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
If you're part of an ESD, please list all ESDs and the average annual financial support received:
Application
How will a vehicle donation fulfill a need that helps further the goals and mission of the VFD?
Additional Information
Submit a copy of the budget for the current fiscal year.
One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
List all VFD vehicles, including make, model and approximate value.
List any completed or pending fundraising plans for the current fiscal year; include the amounts raised and what the monies were or will be used for.
Certification of Application
I understand by submitting this application that the VFD is not guaranteed a vehicle donation from Medina EC.
I am also certifying that this application is complete and the information provided is complete and accurate.
I understand that if the VFD I am representing does receive a vehicle donation that the:
Requesting VFD must assume all liability for the fitness for duty and usefulness of the donated vehicle to the operation of such entity
Requesting VFD accepts vehicle in “as-is” condition with no warranty conveyed
Requesting VFD assumes responsibility for all tax, title and license impact of donated vehicle
Requesting VFD cannot use the donated vehicle for the purposes of fundraising and/or raffling
Requesting VFD must give consent to allow a photograph and/or video of the donation with at least one member of the VFD
Requesting VFD must give consent to media presentation of donation
If awarded a truck, a required five-year waiting period is required before the VFD can be considered for a truck donation
Type Name
Signature
Sign above
Leave this field blank