Car Giveaway Application 2022
Please fill out all of the information in this application to be considered for the Car Giveaway.

DRAGG Inc, A Youth Automotive Program, is looking for a local family in need of a refurbished car!

Responses are due by December 2, 2022 at 5pm.
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First and Last Name *
Street Address, City, Zip Code *
(Area Code) + Phone Number *
Email
Age *
Do you have a California Driver's License? *
Can you obtain auto insurance for the vehicle?   *
Can you keep up with maintenance on the vehicle?
*
Total number of people that live in your household? *
Tell us a little bit about you and your family. *
What type of challenges are you currently dealing with? *
What will you use the car for and why should we pick you? *
Can you be present at the Giveaway event on Monday December 12, 2022  at 5:30pm to accept the vehicle? *
I have read and agree to the 2022 Car Giveaway Official Rules *
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Thank you for taking the time to complete this application.  We will be contacting the top finalists prior to the giveaway and we will announce the winner on Monday, December 12, 2022 at 5:30pm.  
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