Project COPE Donation Form

Project COPE Donation Form Date:
Colorado Springs Utilities will send a confirmation letter within ten business days. At the end of the year, we will send you a letter stating the amount of your annual donation. Please note fields with asterisk () are required to submit this request.
*Name (on the utility bill):
*Address:
*City:
*State:
*Zip:
*Home Phone:
*E-mail Address:
Colorado Springs Utilities Account Number:
*I am requesting to make a contribution of: $5 $10 $15 $20 Other: $
*I would like to make: One-time contribution (selected from above) Monthly contribution (please bill the above amount monthly to my utility bill)

Thank you for your donation. Every dollar makes a difference and goes directly to help local families in need.