Giving Back Application

First name*

Last name*

Street address*

City*

State/Region*

Zip Code*

Email*

Mobile phone number*

Please describe the event you will be participating in.*

Date of the Event*

Month/Day/Year

What 501(c)(3) organization would you like to support?

Organization name and contact email

Is this a solo event or a community event?*

Individual Event

Community Event

Each Giving Back Kit will include 3 shirts. We will do our best to accommodate your size request. Additional shirts are available when you make a donation to the KSKJ Life Foundation.

Who will be helping you with this event?

Requirements: At least a total of 3 individuals. 1 member plus 2 others. List participants separately here. First and last name and email address.

Additional questions? Submit them below.

Terms and Conditions: All participants must adhere to the guidelines outlined in the "Starts With You" kit, including the use of the provided t-shirts and proper documentation of the volunteer event. Volunteer service should be consistent with good citizenship and support important charitable goals of KSKJ Life such as fostering education, preserving the environment, and promoting health and human services. KSKJ Life reserves the right to deny funding to any organization which is not consistent with KSKJ Life’s purpose and mission. Terms and conditions for this program are based on funds availability and are subject to change at any time. A maximum of 50 applications will be granted for the year 2024.