Single Mother Vehicle Giveaway Application 🚗

Single Mother Vehicle Giveaway Application 🚗

Share your details, eligibility information, and upload required documents by August 17, 2026, at 11:59 PM.
Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you a resident of the City of Wilmington, Delaware?
Are you a single mother?
How many children do you have?
Do you have a valid driver's license?
What do you currently do?
In 300 words or less, tell us why you should be selected to receive this vehicle.
How would receiving this vehicle positively impact you and your family?
Upload Verification of Income (two most recent pay stubs, a recent tax return, Social Security/disability benefits statement, or another official proof of income)

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Upload a Photo of Yourself

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Should be Empty: