Online Application | Drive Hope Vehicle Giveaway

1

Applicant Information

Tell us how to contact you and confirm the basic eligibility questions.

Full legal name * Preferred name Street address * City * State * ZIP code * County of residence * Primary phone * Email address * Date of birth * Alternate phone (Optional) Best time to contact Who is helping you complete this application? (Optional)

Preferred contact method *

CallTextEmail

Are you at least 18 years old? *

YesNoUnsure

Are you currently a South Carolina resident? *

YesNoUnsure

Can you attend the giveaway event in person on Saturday, November 14, 2026? *

YesNoUnsure

Has anyone else in your household submitted an application? *

YesNoUnsure

Are you, or is anyone in your household, an employee, officer, director, selection committee member, or immediate family member of someone serving in those roles for Flat Rock Baptist Church or Deal Depot Auto Sales? *

YesNoUnsure

2

Driver and Insurance Eligibility

These identity fields are encrypted and available only through controlled Administrator access.

Driver's license state Driver's license number * Social Security number *Enter 9 digits. This field is encrypted and is never saved in the browser draft. License expiration License status Years licensed

Do you currently hold a valid driver’s license that is not suspended or revoked? *

YesNoUnsure

During the past five years, has your license been suspended or revoked? *

YesNoUnsure

During the past five years, have you had a DUI, reckless-driving conviction, or another major driving offense? *

YesNoUnsure

At-fault accidents in past 3 years Moving citations in past 3 years

Please explain any “Yes” answer or driving issue that could affect insurance eligibility.Only driving-related information is requested here.

Current insurance status

I currently have auto insuranceI do not own a vehicle and do not have a policyMy coverage recently endedOther

If selected, would you be able to obtain South Carolina liability insurance on this vehicle? *

YesNoUnsure

3

Household and Current Transportation

Help the committee understand who depends on your transportation and what options are currently available.

Household information

Adults age 18+ Children age 0-5 Children age 6-12 Children age 13-17 Other dependents Total household size *

Current living situation Monthly housing cost

$

Length at address

YearsMonths

Does anyone in your household have a transportation-related accommodation, mobility, caregiving, or frequent medical-appointment need?Optional. Describe the transportation need only; do not include a diagnosis or medical records.

Current transportation situation

Vehicles available to the household
Year / make / model	Owner	Runs?	Reliable and available?	Monthly cost

How often is reliable transportation unavailable? Typical weekly miles Missed or late essential trips in past 90 days Longest regular trip, miles one way

Describe your current transportation problem. *Explain vehicle condition, shared access, missed work or school, appointments, childcare, safety concerns, or other barriers.

4

Work, Education, Responsibilities, and Budget

Provide honest estimates. Public benefits are included only to understand the full household budget and are not counted against an applicant.

Employer / school / program Location Position / course of study Schedule Employment / enrollment start date

What essential trips would this vehicle make possible? *Examples: work, school, training, medical care, childcare, caregiving, groceries, worship, or other essential responsibilities.

Monthly household resources

Wages / self-employment

$

Social Security / SSI / SSDI / retirement / VA

$

Child support / alimony

$

Unemployment benefits

$

Public assistance or cash benefits

$

Other regular income or support

$

TOTAL GROSS MONTHLY HOUSEHOLD INCOME

$

Essential monthly expenses

Housing

$

Utilities / phone

$

Food / household supplies

$

Childcare / dependent care

$

Medical / prescriptions

$

Current transportation / debt payments

$

Other essential expenses

$

TOTAL ESSENTIAL MONTHLY EXPENSES

$

Amount available for vehicle costs per month

$

Emergency repair savings available now

$

Ability to keep the vehicle operating

A vehicle owner may have ongoing costs for liability insurance, fuel, maintenance and repairs, and annual county vehicle property tax. Initial title, registration, and any applicable state fee will be explained to finalists before the drawing. Do not assume the vehicle is “free to own” simply because there is no purchase price.

Estimated insurance per month

$

Estimated fuel per month

$

Maintenance savings plan per month

$

Other vehicle costs per month

$

After reviewing an itemized estimate, would you be able to keep the vehicle insured and pay normal operating costs? *

YesNoUnsure

Explain your plan for insurance, fuel, maintenance, repairs, registration, and annual property tax. *If you would need help with a specific initial cost, say so. Needing limited assistance does not automatically disqualify you.

5

Your Need and the Expected Impact

Specific examples help reviewers understand how reliable transportation would affect essential parts of your life.

Why do you need reliable transportation right now? *Describe the circumstances that created the need and why your current options are not dependable. How would this vehicle change your household’s day-to-day life? *Be specific about work, school, medical care, caregiving, family stability, safety, or other essential needs. What goals are you working toward during the next 12 months? *Explain how reliable transportation would help you make measurable progress. Is there anything else the review committee should understand?Optional. Include information not covered elsewhere that directly relates to transportation need or responsible vehicle use.

6

References, Outreach, and Authorizations

List two adults outside your household who can confirm your circumstances, then review the outreach and consent sections.

Reference 1

Name * Relationship Phone * Email

Reference 2

Name * Relationship Phone * Email

If selected as a finalist, I can provide the following by the stated deadline:

Valid driver’s license for verificationProof of current South Carolina residenceIncome / benefit documentation or other proof of household resourcesInsurance quote or binder showing the vehicle can be insuredAdditional documents reasonably needed to verify application statements

Optional

Flat Rock Baptist Church outreach

Not used in selection. These choices are voluntary and are not shown to application scorers.

Optional

Deal Depot follow-up

This choice is separate from the giveaway and is not a condition of applying or purchasing anything.

If I am not selected, I would like a Deal Depot representative to contact me about vehicle options.I do not want Deal Depot sales follow-up.

Consent

Event photography and video consent

Photos, video, and audio may be recorded at the event. I authorize Flat Rock Baptist Church and Deal Depot Auto Sales to photograph and/or record me and to use my name, image, likeness, and voice in websites, social media, news coverage, and promotional materials related to Drive Hope without payment.

I have read and consent to the event photography and video authorization described above. *

Consent signature * Date *

Consent

Background check and driving-record consent

I authorize Flat Rock Baptist Church, Deal Depot Auto Sales, and their designated screening providers to obtain a background check and a motor-vehicle record for the limited purpose of evaluating my eligibility for and administering the Drive Hope Vehicle Giveaway. I understand that this authorization does not require the organizers to obtain either report.

I have read and consent to the background check and driving-record review described above. *

Consent signature * Date *

7

Certification and Final Check

Review each statement carefully before signing and submitting.

I certify that the information in this application is complete and truthful to the best of my knowledge. Material false statements or altered documents may result in disqualification.
I authorize Flat Rock Baptist Church and Deal Depot Auto Sales, through designated giveaway administrators, to contact my references and verify information necessary to determine eligibility and administer the award.
I understand that submitting an application does not guarantee finalist status or receipt of the vehicle, and that the final official rules control if there is a conflict with this application.
I understand that the vehicle is used, that I must review and sign separate title/transfer and vehicle-condition documents, and that I must have required insurance before taking possession.
I understand that receiving a vehicle may involve title, registration, insurance, property-tax, and possible income-tax or benefit consequences. Finalists will receive available cost information and should seek their own tax or benefits advice.
I understand that I must be present at the November 14, 2026 event to be eligible to receive the vehicle unless the final official rules state otherwise.
I understand that no purchase, donation, church attendance, profession of faith, or Deal Depot marketing consent is required.

I have read and accept the certification statements above. *

Applicant electronic signature * Date * Time

Final check before submitting * I answered every required question and explained any driving-related Yes answers. I listed two references who may be contacted if I become a finalist. I signed and dated the certification above. My driver's-license number and Social Security number are accurate for verification and background-check purposes.

Before selecting Submit: Review your answers carefully. Sensitive identity numbers belong only in their labeled encrypted fields—never in a narrative response or ordinary email.