Rootswork Annual Membership Dues & Donations Payment Form

Please fill out this entire form. If you wish to join the Rootswork Fuel Group be sure to check the box and fill out all the information in the Fuel Group section. We are a 501(c)3 non-profit and your annual dues and donations are tax deductible as allowed for by law. Thank you for participating!

If you are experiencing financial hardships and cannot afford our membership fee, please email

Please consider fueling Rootswork's community projects with a tax deductible gift

In which Rootswork projects do you want to participate? 
If you wish to enroll in the Fuel Group Check Yes and fill in the Fuel Group part of this form 

Fuel Buying Group Membership Application

Which type of fuel and which supplier do you want to use?
Are you currently a customer of the fuel provider you selected?
Is your mailing address the same as your fuel delivery address?
If the delivery or "service" address for your fuel is in a different location than your mailing address, we need that service address information to confirm your account with your selected fuel supplier.*