Aid and Support After Pregnancy (ASAP) Grant Request Application

For every $500 your council or assembly donates to a pregnancy resource center or maternity home (up to $2,000), Supreme will donate $100. Complete this form and submit supporting documentation to request the grant on behalf of the center or home. Supporting documentation must include either an ASAP Donation Receipt Letter or a copy of a cancelled check drawn from the council's account. A W-9 (U.S.) signed and completed by the pregnancy resource center/maternity home must also be provided as an attachment to this form. The W-9 is not required if you have previously submitted one for the organization or it appears on this map. Organizations in Canada do not need a W-9 form.

Money or items donated to each qualifying organization must be donated between July 1 and June 30 within the fraternal year applied for. Please submit this form within 1 month of your donation, or as soon as possible.

Contact fraternalmission@kofc.org with any questions about the application process or online form.

Please review the grant guidelines before completing the application.

Grant Information

Please select if this grant request is on behalf of a Council or Assembly

Council

Assembly

Council/Assembly Number

State/Province

Type of qualifying organization

Pregnancy Resource Center

Maternity Home

Name of Organization

What organization(s) are they affiliated with

Heartbeat International

Catholic Charities

Past K of C Ultrasound Initiative Participant

N/A

Organization Address

Organization Address 2

Organization Country

Organization City

Organization State/Province

Zip/Postal Code

Organization EIN (US) / CRN (Canada)

Donations

List the total amount collected ($500 minimum) by the council/assembly and donated to the pregnancy center or maternity home. If items were donated, list the estimated value of the items ($500 minimum).

Number of items donated

Donation Date

Funds Donated

Value of Items Donated

Supporting Documentation

Please attach a copy of cancelled check(s) (front and back) drawn on the council/assembly account or an ASAP Donation Receipt Letter(s) . For centers and homes in the United States, a W-9 signed and completed by the center/home must also be attached.

File upload

Grand Knight/Faithful Navigator Name

Member Number