To apply for a grant, please fill out and submit form below to the Automobile Dealers Association of Greater Kansas City Charitable Foundation. Please note an organization can only make one grant request per year. If you prefer, you may download the form from the grants page and submit via mail or email to: ADAKC Foundation 11863 West 112th Street, Suite 200• Overland Park, KS 66210 • foundation@adakc.com

Organizational information

Organization Name:
Contact Name:
Address:
Phone:
Email Address:

Mission Statement:

Describe the organization, including year founded and a brief description of the organization’s primary programs (no more than three):

Please provide information in terms of numbers and characteristics of the people your organization serves:

Project Information

Amount requested ($)

Briefly describe the proposed need of your organization that will be addressed by this grant: Describe how addressing
this need will allow your organization to better serve its clients, in particular children and families in need:

Describe how the funding requested will be utilized. Also estimate when you will begin expending the proposed funding for this request
and when the funding will be fully expended:

Please list what other funding sources are committed to meet this need, and/or others funders you plan to approach for financial support:

Has the organization in the past 2 years received support (monetary or in-kind) from any new franchised, automobile dealer?
If yes, indicate the nature of support, dates(s) and amount(s), and provide the name of the automobile dealer:

If awarded a grant, describe if and how your organization will recognize the Automobile Dealers Association of Kansas City Charitable Foundation
for its grant:

Required attachments:
Program or event budget, (including both income and expenses)

Operating budget (including projected revenues and expenses for your organization)

Copy of IRS Determination Letter