PAGE 2 WEEB 1 CONSORTIUM VERIFICATION FORM Electronic versions available on website

Each of the undersigned certifies that they will participate in this project, that the specified obligations and responsibilities in this project will be met, and that the project will be administered by the public agency or corporation designated.

ADMINISTERING ORGANIZATION

Organization’s Name

Project Director’s Name

Freeland School District

Susie Homer

Project Title

Telephone Area/No

Lighten Up: An exploration of Energy Usage and Energy Efficiency

608.555.5555

PARTICIPATING ORGANIZATION(S)

Organization’s Name Ed’s Hardware

Telephone Area/No. 608.555.5552

Address (Street, City, State, Zip) 1900 Maple Lane, Freeland, WI 55555

Supplying 1/3 or More of the Total Match? (If yes, then CEO must sign.) . Yes . No

Name and Title Ed Jones, Owner

Signature ¾ Ed Jones

Date Signed 11/30/07

Organization’s Name Freeland Chamber of Commerce

Telephone Area/No. 608.555.5553

Address (Street, City, State, Zip) 546 Starling Avenue, Suite B., Freeland, WI 55555

Supplying 1/3 or More of the Total Match? (If yes, then CEO must sign.) Yes No

Name and Title Sam Smith, President

Signature Sam Smith

Date Signed 11/30/07

Organization’s Name WI K-12 Energy Education Program

Telephone Area/No. 715.346.4770

Address (Street, City, State, Zip) UWSP, 900 Reserve Street, Stevens Point, WI 54481

Supplying 1/3 or More of the Total Match? (If yes, then CEO must sign.) Yes No

Name and Title Jennie Lane, Director

Signature Jennie Lane

Date Signed 11/30/2007

Organization’s Name

Telephone Area/No.

Address (Street, City, State, Zip)

Supplying 1/3 or More of the Total Match? (If yes, then CEO must sign.) Yes No

Name and Title

Signature

Date Signed

Use a duplicate of this form if there are more than four participating organizations. WEEB (Rev.6/07)