SUNFLOWER FUND Application Form

Full Application Form Accepted in American Sign Language or in Written English.
SUNFLOWER FUND

In alignment with the Kansas Association of the Deaf’s mission, which is to PRESERVE, PROTECT, and PROMOTE the civil, human, linguistic, and rights of Deaf Kansans. The Sunflower Fund is for any Kansas Deaf individuals (any age) pursuing their education or personal skill building their skills in their specific fields of interests, advocacy, and activism. As a result, Deaf leaders are created to contribute and influence the elevation and growth of Deaf Leaders and the Deaf Community.

YEAR AWARD AMOUNT: up to $1,000 per individual(s) (The maximum amount from the fund for total awards annually is $2,000)

Can be awarded for personal skill building and educational endeavors such as but not limited to the following categories:
- Deaf Leadership Camps
- Deaf Summer Camps (other than NAD Youth Leadership Camp)
- Any Deaf Centered Conferences
- Workshops/Seminars/Trainings
  - Skill-Specific
  - Advocacy & Social Justice
  - Parliamentary
  - Deaf Interpreters
  - Deaf Studies, Intersectionality and Deaf Communities Courses
  - Legislation, Policy Making, Politics, and Campaign
- Certificates or Degrees from Post Secondary Educational Institutes
- and many more that influence and elevate the growth of Deaf Leaders and the Deaf Community.
ELIGIBILITY CRITERIA
- Applicant(s) must be Deaf (include people who may identify as Deaf, DeafBlind, Deaf+, Hard of Hearing, or Late-Deafened). Must submit an audiogram signed by a licensed audiologist, otolaryngologist, physician, or certified technician.
- Applicant(s) must be a Kansas Resident. KAD will use the applicant's State Issued ID or Driver's License as proof. (For below age 18, if not have a State Issued ID, use parent/guardian’s).
APPLICATION PERIOD: Applications are accepted at any time during the year.
APPLICANT INFORMATION
Name of Applicant*
If selected as the winner, this name will be to whom the check will be issued to.
Applicant's Date of Birth*

MonthDayYear
Applicant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Text Number*
Please enter a valid phone number
Video Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Applicant's Proof of Date of Birth and Address:*

Please upload an image of your Drivers License or qualifying state ID.
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ENDEAVOR DETAILS

Provide as much information as you can to strengthen your chances of being awarded.
Endeavor Categories*

Deaf Leadership CampsDeaf Summer Camps (other than NAD Youth Leadership Camp)Any Deaf Centered ConferencesWorkshops/Seminars/TrainingsCertificates or Degrees from Voc-Tech Schools, Community Colleges or UniversitiesOther
Award Amount Request*
type a dollar amount
Link to your personal website or social media account:
If available
Name of Payee (cannot be applicant's name)*
If selected as the winner, this name will be to whom the check will be issued to.
Payee's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tell us about your skill-building or educational opportunities:*
If in ASL, please provide a link to the ASL version
Tell us how your skill-building or educational opportunities will influence or contribute to the elevation of yourself as a Deaf Leader, and to the expansion, enhancement of the Deaf community, and Deaf Leadership.*
If in ASL, please provide a link to the ASL version
Tell us how your Endeavor aligns with KAD's mission, which is to PRESERVE, PROTECT, and PROMOTE the civil, human, linguistic, and rights of Deaf Kansans:*
If in ASL, please provide a link to the ASL version
Tell us about yourself:*
If in ASL, please provide a link to the ASL version
Upload supporting images or files of your registration form/invoice and Audiogram:

Submit registration form or invoice that you wish to attend
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AGREEMENT of the SUNFLOWER FUND TERMS by Applicant.

Must be signed before applications can be considered and awards given.
The SUNFLOWER FUND TERMS

If I am awarded, I agree to share my experience by doing one of the following within three (3) months after completing my endeavor. I will work with the KAD Youth Program Coordinator on this.

1) Write an article for the KAD Newsletter

2) Create a vlog for the KAD Newsletter

3) Give a presentation at a KAD Board Meeting or event

By accepting this Sunflower Fund award, I agree to release the Kansas Association of the Deaf (KAD), and its officers, directors, and members from any liability, loss, damage, cost, or claim that arises from my participation in the scholarship program. KAD reserves the right to withhold awards in any given year, and to modify or terminate any scholarships at its sole discretion, with or without notice.

By accepting this Sunflower Fund award, I give the Kansas Association of the Deaf (KAD) permission to publicly announce my name, image, award amount, and endeavor in any of its public relations materials.
To be signed by the recipient named as applicant. By signing this document, the recipient agrees to the Sunflower Fund Terms:
Applicant Signature*

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Applicant Name*

First NameLast Name
SUNFLOWER FUND AWARD NOTICE:

Fund Award Criteria: Awarding of the fund is contingent upon the strength of the application, fund availability, the proposed individuals' endeavor merit, and the volume of applications received. Receipt of a fund is not guaranteed.

Confidentiality Assurance: Personal details such as age, address, and driver's license number are treated with utmost confidentiality and will not be disclosed. Information pertaining to the awarded endeavor may be shared publicly.

Selection Process: The KAD Board of Directors convenes as requests come in, to evaluate and vote by majority to approve the request.

Announcement of Winners: The KAD Board of Directors will contact the selected winners before announcing fund recipient(s) on KAD’s website, social media, and newsletter.

Procedures: The winner needs to submit a proof of acceptance or invoice for the KAD Treasurer to pay directly to (will not give money to the winner).
Should be Empty:

APPLICANT INFORMATION

ENDEAVOR DETAILS

AGREEMENT of the SUNFLOWER FUND TERMS by Applicant.