Name of organization or individual:

Contact name:

Address:

Phone:

Email:

Are you a registered non-profit?

Yes   |   No

Is this a planned or an existing organization/charity?

Planned   |   Existing

Describe the nature of your business, organization or charity and how it relates (or will relate) to intellectual disabilities:

Describe how you, your business or organization would benefit from a CKF grant:

Are resources available (web sites, printed literature, business plans, etc) that can help us learn more about you and/or your organization? Please explain and include any web links, etc. (Additional literature can be mailed with a printed form or attached to e-mail):

Anything you’d like to add?

Applications will be reviewed by the awards committee. Further information may be requested from potential candidates before a grant decision is made.