Download the Agency Application – New Applicant

or the Agency Application – Renewal

AGENCY REQUIREMENTS
Revised April 2010

Funds generated by the Choose Life specialty license plate are distributed quarterly to qualifying front-line life affirming agencies that counsel abortion vulnerable women (pregnancy centers and maternity homes) based on the following criteria.

Any agency requesting “Choose Life” funds must first submit an application along with documentation listed below. Applications are available by calling Choose Life of Georgia. Each agency shall be required to re-apply and submit documentation annually.

• Application or Renewal Application
• Copy of Articles of Incorporation (NEW APPLICANTS ONLY)
• Current year IRS Form 990 including Schedule A, if donations over $25,000
• Valid Charitable Organization Registration from the Secretary of State if annual donations are over $25,000 www.sos.state.ga.us/securities Application Form C-100 / 5 pages
• Copy of IRS Tax Exemption Letter – 501(c)(3) (NEW APPLICANTS ONLY)
• Annual Financial Statement
• Copy of most recent budget signed by Treasurer of the Board of Directors
• Copy of letter stating operation under religious organization, if applicable
• Copy of certificate of affiliation or page 1 of renewal application & copy of fee check with nationally recognized pregnancy support organization such as NIFLA, Care Net, etc.
• List three references on separate paper with name, address, phone number and relationship to the agency (NEW APPLICANTS ONLY)
• Certificate of Adoption Training (minimum 8 hour course) within the past 12 months from one of the following agencies:

  Infant Adoption Training Initiative 888-440-9800

  Bethany Christian Services 770-455-7111 or 706-576-5766

  Covenant Care Services 478-475-4990

• After initial qualifying, agencies are also required to complete a Quarterly Statistic Report before receiving funds.

Agencies are responsible for complying with a non-discriminatory policy to help all women choose life regardless of race, color, religion, national origin, age, familial status or physical disability and counsel for adoption when applicable.

No agency that promotes, advocates, refers for or performs abortions shall be eligible for any Choose Life funds.

Funds are distributed based on the number of Choose Life Tag sales in the county of residence of the agency, statistics from the Quarterly Statistic Report, and special needs as approved at the discretion of the Board of Choose Life of Georgia, Inc. More information here.