KCDD Unsolicited Grant Application - FY 2024 1. Grant Application General Information KCDD = Kansas Council on Developmental Disabilities IDD = Individuals with Intellectual or Developmental Disabilities Self-Advocate = An individual with Intellectual or Developmental Disability DD Act = Developmental Disabilities Assistance and Bill of Rights Act AIDD = Administration on Intellectual and Developmental Disabilities OK Question Title * 1. Applicant Agency/Organization's Legal Name Organizational Name Address Address 2 City/Town State/Province ZIP/Postal Code County Email Address Phone Number OK Question Title * 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 OK Question Title * 3. Authorizing Official (Full Name) OK Question Title * 4. Federal Employer ID Number (FEIN) OK Question Title * 5. Organization Type Public Nonprofit Private Entity/LLC OK Question Title * 6. Grant Director Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number OK Question Title * 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 OK Question Title * 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) OK Question Title * 9. Grant Range Period (i.e., Monthly Range/Calendar Year) OK Question Title * 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) OK Question Title * 11. Please describe how the grant will incorporate self-advocacy and self-advocates thought the project cycle. OK NEXT