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        <BusinessNameLine1>The Jeff Gordon Childrens Foundation</BusinessNameLine1>
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        <ZIPCode>28262</ZIPCode>
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    <Preparer>
      <Name>Phillip G Wilson</Name>
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          <PersonName>Patricia Kriger</PersonName>
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            <State>NC</State>
            <ZIPCode>28262</ZIPCode>
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          <PersonName>Stokely G Caldwell Jr</PersonName>
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            <City>Charlotte</City>
            <State>NC</State>
            <ZIPCode>28246</ZIPCode>
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            <City>Harrisburg</City>
            <State>NC</State>
            <ZIPCode>28075</ZIPCode>
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          <Title>Treasurer</Title>
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          <PersonName>Michael Holland</PersonName>
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            <City>Charlotte</City>
            <State>NC</State>
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      </UndistributedIncome>
      <SupplementaryInformation>
        <ContributingManager>Jeffery M Gordon</ContributingManager>
        <AppicationSubmissionInfo>
          <RecipientName>Katie Harty</RecipientName>
          <RecipientUSAddress>
            <AddressLine1>4345 Papa Joe Hendrick Blvd</AddressLine1>
            <City>Charlotte</City>
            <State>NC</State>
            <ZIPCode>28262</ZIPCode>
          </RecipientUSAddress>
          <RecipientPhoneNumber>7044557424</RecipientPhoneNumber>
          <FormAndInfoAndMaterials>Grant application is available at www.jeffgordonchildrensfoundation.org. Applications should include IRS letter of determination, most recent Form 990, program summary, budget, itemized program budget, list of other funds received for this program, Board of Directors list, most recent audited financial statements and annual report. See application for further details.</FormAndInfoAndMaterials>
          <SubmissionDeadlines>August 1</SubmissionDeadlines>
          <RestrictionsOnAwards>Consideration is limited to section 501(c)(3) tax-exempt organizations with programs that support the physical and emotional health of children, medical research for childhood diseases and patient assistance programs for children. Programs must be based in the United States and may not discriminate by race, religion, color, creed, sex, age or national origin. Funding is awarded in amounts up to $15,000 per grant. See policy guidelines for further details.</RestrictionsOnAwards>
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          <RecipientPersonName>Partners in Health</RecipientPersonName>
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            <AddressLine1>888 Commonwealth Avenue</AddressLine1>
            <City>Boston</City>
            <State>MA</State>
            <ZIPCode>02215</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>To facilitate cancer care in Rwanda. In collaboration with Partners In Health and the Dana Farber Cancer Institute and through the development of a Comprehensive Cancer Program, children with cancer living in Africas most densely populated region will begin to receive increased access to treatment. This includes prevention, diagnosis, chemotherapy, radiation, surgery and follow-up care.</PurposeOfGrantOrContribution>
          <Amount>430838</Amount>
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          <RecipientPersonName>Miscellaneous less than 3000</RecipientPersonName>
          <RecipientUSAddress>
            <AddressLine1>4345 Papa Joe Hendrick Blvd</AddressLine1>
            <City>Charlotte</City>
            <State>NC</State>
            <ZIPCode>28262</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>Various support.</PurposeOfGrantOrContribution>
          <Amount>19616</Amount>
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          <RecipientPersonName>CureSearch for Children's Cancer</RecipientPersonName>
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            <AddressLine1>4600 East West Highway</AddressLine1>
            <City>Bethesda</City>
            <State>MD</State>
            <ZIPCode>20814</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
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          <PurposeOfGrantOrContribution>Phase 1 Long-Term Follow-Up Study aimed at collecting data from pediatric cancer patients and their doctors to compare their treatment protocols with long-term health histories, in order to develop less invasive treatments in the future. The study is being conducted by CureSearch in conjunction with the Childrens Oncology Group.</PurposeOfGrantOrContribution>
          <Amount>200000</Amount>
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          <RecipientPersonName>Hospice of Western Reserve Inc</RecipientPersonName>
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            <State>OH</State>
            <ZIPCode>44110</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>To provide palliative end-of-life care, caregiver support and bereavement services to pediatric cancer patients throughout Northern Ohio.</PurposeOfGrantOrContribution>
          <Amount>10000</Amount>
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            <State>IL</State>
            <ZIPCode>60067</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>To train hospital professionals, by providing them with the tools and resources they need to integrate support for siblings into pediatric oncology care.</PurposeOfGrantOrContribution>
          <Amount>10000</Amount>
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            <City>Fort Worth</City>
            <State>TX</State>
            <ZIPCode>73177</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>To fund childhood cancer patient support and treatment programs in the State of Texas</PurposeOfGrantOrContribution>
          <Amount>75000</Amount>
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          <RecipientPersonName>Monroe Carell Jr Children's Hospita</RecipientPersonName>
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            <AddressLine1>Vanderbilt University Medical Ctr</AddressLine1>
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            <State>TN</State>
            <ZIPCode>37203</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>Funding will provide the Children's Hospital with an exemplary, multidisciplinary, comprehensive school support program that provides families and schools with information, guidance, and direct services addressing the educational needs of patients treated for cancer.</PurposeOfGrantOrContribution>
          <Amount>15000</Amount>
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            <State>PA</State>
            <ZIPCode>15224</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>To provide multidisciplinary care for patients aged 15-22, a traditionally underserved population in terms of age appropriate programming. Offering psychosocial support, fertility counseling and peer support groups.</PurposeOfGrantOrContribution>
          <Amount>15000</Amount>
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            <City>Concord</City>
            <State>NC</State>
            <ZIPCode>28025</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>$130,000 for the purchase of three Giraffe Omnibeds and two shuttles$50,000 to build and outfit a Family Resource Library to support patients and families at the Jeff Gordon Childrens Hospital"</PurposeOfGrantOrContribution>
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            <ZIPCode>10021</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>Temporary housing for pediatric cancer patients and their families.</PurposeOfGrantOrContribution>
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            <ZIPCode>46204</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
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          <PurposeOfGrantOrContribution>$300,000 as payment 3 of 5 of our 2009 pledge to support the Jeff Gordon Childrens Foundation Pediatric Cancer Lab$5,000 to assist in purchasing toys for the Magic Castle Cart</PurposeOfGrantOrContribution>
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          <RecipientPersonName>Hendrick Marrow Program</RecipientPersonName>
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            <ZIPCode>28262</ZIPCode>
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          <RecipientRelationship>N/A</RecipientRelationship>
          <RecipientFoundationStatus>Public</RecipientFoundationStatus>
          <PurposeOfGrantOrContribution>$140,000 for patient assistance programs for children receiving marrow or cord blood transplants$60,000 to support efforts to build/diversify the Be The Match Registry</PurposeOfGrantOrContribution>
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        <DisbursementsCharitablePrps>827</DisbursementsCharitablePrps>
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        <DisbursementsCharitablePrps>38217</DisbursementsCharitablePrps>
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        <DisbursementsCharitablePrps>1125</DisbursementsCharitablePrps>
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        <AdjustedNetIncome>0</AdjustedNetIncome>
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