Car Donation Application
Please complete the application in its entirety (use N/A or Not Applicable if the question doesn't pertain to you). We appreciate your complete and honest answers. Failure to do so may resolve in an application rejection.

PEARL, on occasion, provides those most in need with a donated vehicle. This is the first step in a three step process to determine the successful candidates for vehicle donations. If your initial application is approved, you will be asked to complete a second form. At that time, the most qualified candidates are presented to the Transportation Programs Selection Committee. We don't have or keep an inventory of vehicles; the wait for a successful candidate to receive a car may be weeks or months. 

To qualify for a vehicle donation from PEARL, you or your child/ children must:

  • Be a single parent with at least 50% legal custody to at least one child under 18 years of age.
  • Reside within 30 miles of our Longmont service area (preference in donations are first given to St. Vrain Valley School District Residents).
  • Be identified as someone in need of private or public assistance, or currently receiving services.
  • Be actively working, looking for work, going to school, or donating your time. We love to see that you are giving back to your community as the people in the community have graciously given to you in this time of need.

Proof will be required to be considered for a vehicle donation possibly including: filed child custody arrangements, divorce decree, pay stubs, etc. Additionally you will be required to provide insurance, should you receive a donated vehicle and agree to PEARL's No Re-Sale Policy which states that you may not sell the car for your own profit within 6 months of receiving the donation. 

After completing this application, please email a copy of your current, valid driver's license to: info@pearlpromise.org for faster consideration.
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Email *
Full Legal Name
 *
Todays Date *
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Address
Phone Number (can you receive texts?)
Email
 *
By continuing this application, you confirm you meet the requirements for assistance as listed above. You also confirm that you are a single/divorced/widowed parent at least one minor child in your legal custody.   
Please check the answer below that best fits your situation.
 *
Required
Are you at least 18 years of age and have a VALID drivers license (PERMIT NOT ACCEPTED) that you can show proof of today by emailing as instructed above? *
Date of Birth *
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DD
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YYYY
Please list the names & ages of any minor children in your care/household. *
Do you have 50% (or more) legal custody of the child in your care? *
Are there any other adults (18 years of age and older) in the home?  If so, please list their names, ages, and relation to you, as well as their employment status.
 *
How did you hear about PEARL? Please list the person or agency that referred you.
What are your essential needs when it comes to a vehicle? Number of seats, room for car seats, automatic or standard transmission? 
***We are ONLY looking for specific needs to help accommodate you and your children. We do NOT applications that request makes, models, colors, or drive train.***
 *
Describe the circumstances or specific events in your life that caused this immediate need for a vehicle. *
Do you currently have a vehicle that runs and do you own this vehicle? If not please provide an explanation of who owns the vehicle, and what the plan for that vehicle would be if you were to receive a donated car?

NOTE: We ask that you donate your vehicle to PEARL in exchange for receiving a donated vehicle, even if it is not in running order. If you have a vehicle registered in your name that you would not be willing to donate in exchange, please list why. 

Use N/A if you current do not have a vehicle.
 *
What is your Employment status? (Please be specific and include: job title, company, length of employment, wages, and hours worked per week.) *
We require the recipients of donated vehicles to register and plate the vehicle through the state of Colorado, insuring the vehicle beforehand and providing PEARL proof of all listed above. Will you be able to do these things on your own financially? *
Are you currently enrolled in school? If so, where are you enrolled and what are you studying? *
What public assistance benefits are you currently receiving? Please check ALL that you have received in the past year.
 *
Required
Have you received any assistance from the list below (non-government)? *
Required
List any educational assistance you are currently receiving (Including grants, student loans, etc.)  *
List ALL OTHER monthly income you are receiving. Must list ALL sources & include their name and the amount they help you with.
NOTE: Be sure to include salary/ wages, child support, social Security, disability benefits, tax refund, etc.
 *
Are you currently a participant in any of our programs? NOTE: Participation is NOT a requirement to be a participant. *
Required
Have you received support/ services from PEARL in the past year? Please check ALL that apply *
Required
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