KCDD Unsolicited Grant Application

1.Applicant Agency/Organization's Legal Name

Organizational Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

County

Email Address

Phone Number

2.Fiscal Agent (only complete if a different Fiscal Agent is used to process funds or sign contracts on your behalf).

Fiscal Agent Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

3.Authorizing Official (Full Name)

4.Federal Employer ID Number (FEIN)

5.Organization Type

Public

Nonprofit

Private Entity/LLC

6.Grant Director

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

7.Grant Information (i.e., Title, Target Stakeholders, Proposed Impact & Outcomes)

Grant Title

Target Audience/Stakeholders

Number of Individuals with IDD

Number of Parents/Guardians (of Children/Adult with IDD)

Number of Caregivers (of Children/Adult with IDD)

Kansas County Targets

Expected Grant Outcomes

8.Annual Financial Request to Support Grant (dollar amounts required)

Grant Request for KCDD

Grantee In-Kind/Matching

Other Funding Sources

Total Project Cost (One Year)

9.Grant Range Period (i.e., Monthly Range/Calendar Year)

10.KCDD State Five-Year Goal(s) that will be addressed in this grant (see 2022-2026 KCDD Five-Year Plan)

Building & Support IDD Advocacy & Self Advocacy in Kansas

Transition Across the Lifespan for IDD Community in Kansas

Innovative Solutions for Kansas' IDD Waitlist

Increase Support/Resources for Underserved and Underrepresented IDD Communities across Kansas

Increased utilization of Supported Decision Making for IDD Community in Kansas

Increase Protections from Abuse, Neglect, and Exploitation (ANE) for IDD Community in Kansas

Other (please specify)

11.Please describe how the grant will incorporate self-advocacy and self-advocates thought the project cycle.

Current Progress,

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KCDD Unsolicited Grant Application - FY 2026

1.Grant Application General Information