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CJPP Application for Continuation of Implementation Funding Page 4 of 5 <br />(B] Check all services that apply On Site Off Site <br />[ 1 ] ~1 Substance Abuse Treatment E~.J Assessment /J EG <br /> EG ROPT Eli (~ <br /> Ed IOPT 6Ci ^ <br /> 6G Support Services EG 66 <br /> GEi After Care ~J ~1 <br /> EG Drug Screens EG 66 <br /> ^ Other ^ ^ <br />[2] G~ Educational Services ~ ~ <br />[3] 6/J Job Development Services ~fj 6(j <br />[4] ~! Cognitive Behavioral Intervention 6/j 6/j <br />[5] EG Domestic Violence Services 6(j 6(j <br />[6] ~J Life Skills (~j 6/j <br />[7] ^ Sex Offender ^ ^ <br />[8] ^ Others ^ ^ <br />11. Service Provider Information <br />(A] List the NON-CONTRACTED (i.e., services at NO COST to CJPP) Service Providers to the <br />program. Attachment 2 <br />Attach a Copy of Memorandums of Agreement (MOA's) in attachment section for FY 2011 - <br />2012. MOA's should be maintained in Program files on site. <br />-_ __ <br />'Orange/Chatham Probation & Parole; Joint Orange-Chatham Community Action, Inc; Club <br />Insight; PTA Thrift Shop, Inc; Central Carolina Community College; Rape Crisis Center of Orange <br />County; Orange County Literacy Council; Orange County Health Department; Orange Vocational <br />Rehabilitation; 15B Division of Community Corrections Drug Treatment Court; Shared Visions <br />Credit Counseling; Employment Security Commission; Orange Public Transportation; OPC <br />LME/TASC; El Futuro; Oxford House; Durham Technical Community College -Human <br />Resources Dept; Durham County DSS; and Chatham Transit <br />(B] List the CONTRACTED (i.e., services at COST to CJPP) Service Providers to the program. <br />Attachment 3 <br />Attach a Copy of Proposed or Signed Contracts in attachment section for FY 2011 - 2012. <br />Contracts should be maintained in Program files on site. <br />Oran e County Government and Freedom House Recovery Center <br />Ptease Note: Attachments are required for contracts and MOA's for FY 2011 - 2012. <br />12. Project Income <br />6 <br />http://cjpp.doc.state.nc.us/apps/CJPPFiscal/CJPPFiscalController?ACTION=SaveForm 2/7/2011 <br />