TIDES FOUNDATION
Po Box 29903 San Francisco, CA 94129-0903
Tel: 415.561.6400 @ Fax: 415.561.6401
deathpenalty@tides.org
DEATH PENALTY MOBILIZATION FUND STATE STRATEGIES APPLICATION FORM
Cover SHEET
ORGANIZATION NAME: Kentucky Coalition to Abolish the Death Penalty
EXECUTIVE DIRECTOR: Rev. Patrick Delahanty
CONTACT PERSON Rev. Patrick Delahanty TITLE: Chair, KCADP Board
for Grant & Legal Issues
ADDRESS: PO Box 3092
City: Louisville STATE: Kentucky ZIP: 40201
PHONE NUMBER: (502) 636-1330 Fax NUMBER: NONE
E-MAIL ADDRESS: staff@kcadp.org WEBSITE: www.kcadp.org
YEAR FOUNDED: 1988 FIscAL YEAR END: December 31, 2009
ANNUAL ORGANIZATIONAL BUDGET:
$50,781.09
NET ASSETS (FUND BALANCE) AS OF TODAY:
# PAID FULL TIME STAFF: 1 # PAID PART TIME STAFF: 1 # VOLUNTEERS: _45 -
50
ORGANIZATIONAL MISSION STATEMENT: To abolish the death penalty in Kentucky
ORGANIZATIONAL DESCRIPTION: KCADP is a non-profit organization incorporated in the State of Kentucky
committed to ending the death penalty in Kentucky by educating residents of the commonwealth about why it is in
their best interest to abolish the death penalty, by organizing and mobilizing throughout the commonwealth, and by
engaging in advocacy efforts that move constituents to persuade the governor and the General Assembly to
abolish the death penalty.
DESCRIPTION OF PROGRAM RECOMMENDED FOR FUNDING: (if applicable) NA
AMOUNT REQUESTED: $80,000
PROJECT BUDGET: (if applicable) NA
IRS EMPLOYER IDENTIFICATION NUMBER (EIN):
If you have a Fiscal Sponsor, see next page __61-1169551
Tax Status: [_|Incorporated, Exemption Pending {_501(c)(3) Private Foundation
X 501(c)(3) Public Charity [}501(c)(4) Social Welfare Org.
Other tax status:
If your organization has a Fiscal Sponsor, we require (1) a completed Organizational Summary Sheet
from your Fiscal Sponsor as the legal entity receiving the grant and (2) a copy of the agreement between
your organization and your Fiscal Sponsor.
FISCAL SPONSOR ORGANIZATION:
EXECUTIVE DIRECTOR:
ADpRESS:
City: STATE: ZIP:
PHONE NUMBER: Fax NUMBER:
E-mail ADDRESS: WEBSITE:
YEAR FOUNDED: FISCAL YEAR END:
ANNUAL ORGANIZATIONAL BUDGET:
