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s6didn 5:Adm=E9mpinoN <br /> If you have not received CDBG or HOMEfunding in the past three(3)years,please provide the <br /> following information. Agencies and member governments that have been funded in the past three(3) <br /> years and member governments carrying out projects entirely with their own staff may omit this section. <br /> If your organization has received CDBGor HOM Efunding in the last three(3)years and is omitting this <br /> section, please check this box: ❑ <br /> A. Organization <br /> What isyour organization's. . . <br /> 1. Mission statement? <br /> 2. Incorporation date(Month and Year)? <br /> 3. Estimated Total Agency Budget for FY2014-2015?$ <br /> 4. Total number of agency staff(full time equivalents): <br /> B. Agency Track Rewrd <br /> Rease describe your agency's experience and ability to carry out the proposed project. (This may <br /> indude your past achievements in carrying out similar projects, experience of key staff, collaborative <br /> relationshipswith other agencies,or any other features relating to agency capacity that you consider <br /> relevant). <br /> Q Board of Directors <br /> 1. How many Board Members should your organization have according to your by-laws? <br /> 2. How many Board Membersdoesyour organization actually have at this date? <br /> 3. How often does the Board meet? <br /> 4. What was the actual attendance at each of the last three regular Board meetings? <br /> 5. Have you failed to reach a quorum at any Board meetings in the last 12 months? <br /> 6. What efforts do you make to ensure that your Board represents the community it serves? <br /> Page 8 of 9 <br />