King's Daughters is very happy to consider AED applications from everyone again this year for 2021. However AEDs will be awarded to those with the biggest need in our communities. Please take your time completing this application as it will help us assess those with the greatest need. For questions, please contact Scott Hill at scott.hill@kdmc.kdhs.us or by phone to (606) 408-0455

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* 1. Name of person completing application:

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* 2. Your phone number:

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* 3. Your email address:

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* 4. Name of organization requesting AED:

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* 5. Organization's address:

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* 6. Name of CEO/chief/director (if different from applicant):

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