<>

Write off the car, not the kid! ®

Grant Inquiry Form

Please provide all relevant information below.

 For Profit    Not For Profit

Yes

Yes

Yes

No

No

No

For Profit
 Yes    No

Yes

Yes

Yes

No

No

No

Will the grant, for which you are applying, be used to help kids directly?
 Yes    No

Yes

Yes

Yes

No

No

No

Will anyone other than kids benefit from the money received from this grant?
 Yes    No

Yes

Yes

Yes

No

No

No

Will you be able to formally track how the funds are spent?
 Yes    No

Yes

Yes

Yes

No

No

No

Have you ever applied for and received this grant in the past?
 Yes    No

Yes

Yes

Yes

No

No

No

Are you representing a non-governmental organization?
Safety Code*
Pick  964from the list of numbers.
477964652454844747