Welcome to the Abbott Medical Optics (AMO) Charitable Donations Online Application

Overview

The online application process is comprised of two steps. STEP 1 is the Qualification Test and STEP 2 is the Application.  The Qualification Test in STEP 1 outlines AMO's charitable donation policy. In order to proceed to the application, requesting organizations must review this policy and verify that their organization/entity and program meets the criteria. The application requires text and numeric entries and certain document attachments to be uploaded.  The Required Information section below is provided to help you prepare for the application submission.  Please note that the application, once started, is not saved for future use and combined attachments are not allowed. For example, if you were applying for a mercy mission, Physician’s State Medical License and Program Budget could not be submitted as a single PDF upload.

Please note that submitting an application does not guarantee approval of the request and it may take up to 90 days to return a response.

REQUIRED INFORMATION

Please be prepared to answer or enter into the application:

Your Organization:

  • How were you referred to AMO's giving program?  AMO Employee? Other?
  • Organization Name (“Organization”) 
  • Organization Address
  • Organization City
  • Organization Country
  • Organization Zip
  • Organization Phone Number
  • Organization Executive Director
  • Organization Contact Person
  • Organization Contact Title
  • Organization Contact Phone
  • Organization Contact Email Address
  • Description of AMO Employee Involvement in Organization (if applicable)
  • Recipient’s relationship to AMO (if applicable)
  • Is organization funded by a government agency? (YES NO)

Your Cause:

  • Program/Project Name
  • Type of Donation:
    • Mercy Mission: in-kind product for underserved
    • Other Charitable
      • In-kind product
      • Cash donation
  • Date In-kind Product Needed (if applicable): mm/dd/yyyy
  • Start and End Date of Project/Program/Event
  • For In-Kind Product Requests:
    • Date Product Needed
    • Product Name and Quantity
  • Cash Amount (if applicable)
  • Number of people being served by program/project
  • Geographical areas being served by program/project
  • Other funds committed for this program/project
   
Please be prepared to attach the following documents:

Your Organization:

  • Brief description of the organization or organization brochure (PDF, DOC, JPG, PNG or TXT)
  • List of other corporate and foundation supporters
    (PDF, DOC or TXT)
  • Proof of organization's non-profit status
    (for example, in the U.S., Internal Revenue Service's letter of determination, 501(c)(3); PDF or DOC)

Your Cause:

  • Brief Description of Program/Project (Including Needs Statement and Objective; PDF, DOC or TXT)
  • Budget for Program/Project
    (PDF, DOC or TXT)
  • For Mercy Mission Requests: Physician’s State Medical License
    (PDF, DOC, JPG or PNG)
 

STEP 1: QUALIFICATION TEST

Please answer the following questions to verify that your request meets AMO’s criteria for charitable donations by selecting the appropriate statements:
 

My Entity/Organization is (select one):

My entity is a public charity with tax-exempt status as defined by Section 501(c)(3) of the Internal Revenue Code or other not-for-profit entity or organization that is organized and operated for charitable purposes;
- OR -
My entity is a not-for-profit entity or organization that is organized and operated for charitable purposes for the public good and no one individual benefits.
 

My Program/Project/Event is (select one):

My program or project is a charitable program or charitable event, reduces human suffering through expanding awareness of disease states, their prevention and treatment, and/or enhancing support and access to care for under-served patients;
- OR -
My program or project is for support of community services or community organizations
 

If the donation request is approved, please confirm each of the following (select all):

The donation would not be used for lobbying purposes or to support political campaigns;

The donation would not be used to reward or induce customers for prior or future business;

The donation would not be used for capital projects;

The donation would not be made on behalf of an AMO customer; and

The donation would not result in a financial benefit accruing to AMO.

 

STEP 2: