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DocuSign Envelope ID: B701CF6A-1C9A-46CB-9234-56F771D80955 - continued
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<br /> „ CA000 rrAG0E (Each ph,grai req■,!, has a Sell arate app ctiCtion )
<br /> ay Applicant C arrhrr
<br /> Acpiicact OrganitriulUchn,:5 tegall Nama: YMCA f q „A,Tte.la
<br /> Aosititant Organ teutkyl's Addrossu CenteT D . Ste. 200. Raleigia,
<br /> AtiP,p C?A 'Organirstion's Nola itinU Address: 980 r,qatin LJ th Of ruggr. 1,00911$00„0„(Chzipel H V V N IC; 27E14
<br /> Applicant Organ itratibit Wei,:)Address: imtutiv.ir triCA7rgistpal
<br /> Executive Director: Doug, ihicitliiian Cruel Financial 0Difico Duran H citing
<br /> Tele:phone Numb°it 7 -P22 Brhan.b1 uffnu a n "00,01 CAT itthaltitt o trg
<br /> DUNS N 11 Elle r: 4,8860182,0091,
<br /> IS) if rtslisopfri4i0?0r„trig Contact info rmatiga
<br /> ProjectlFinggram Name: Dograslaing
<br /> ProjectIP'rOgrarfl mart Contact and TVIln:, T,-,,:mttiP00!" P' iatl Director
<br /> 'Telephone N bort 91 9,-98621 4 6 E-N1 Tarni.PiciforitginfiliCATrinitiolc.fera,
<br /> e) Funding Request identifictithat,
<br /> TEl Prrui,ectiPr ograM COSt„ S291.708 Totai Au Ott of Funds : $210000
<br /> Proposed Use of Funds P
<br /> uois U Cr St cid ru rrRIrn)7 Ft!:rids 'MD support Pronram iiiinanitgoLausl
<br /> ,Student Coordinator posit ipri aigiertou COT/tracts. and itirogram matoriais.
<br /> PiciaSe (::110■Ck types, 500,1/roes, and a0i o0.00.107 tS o fliniding bitting roots eSled, You must submit on
<br /> Auiplicali(WI package tor each 'funding scurat. 'The Panicipaarip juris resv,rves the ri,ght
<br /> „Qidd projects from any funding source, ,rs,1 elk:jiddayn and '',uniding constraints.
<br /> Hilman Services: HZ cantor()sr1,000 [F] ch:a pell Hill $7„000 Orangc:, Couttry $1o,Dop
<br /> d), To tiie best of my knowictige and belief all initsTric ition and date in this application ig•
<br /> true and cuurent. The doccutent ha been ,000tit1y authorized by the governing hoard of the
<br /> applica,0.t.
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<br /> inancial Officer/ffl D2'le
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<br /> 1taomgrang Board„PdreSidetA), Date
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