Orange County NC Website
z <br />A GRANT APPLICATION <br />TO <br />CHILD DAY CARE SECTION Coo r,— %7 <br />NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES ` J� V <br />Type of Grant Requested: Resource and Referral X School -Age Child Care <br />1. Name of Applicant Agency: Agricultural Extension-Service <br />Address: <br />386 Mad !i±1Qbu-uwgh9N6 <br />Telephone: qlg - <br />Contact Person:' Mary Fannin <br />Type of Agency: X Public Private Non - Profit <br />Federal Tax ID #: 56 -6000 -756 <br />2. Project Name: 4 -H Science Project <br />Location: 306 Revere Road, Hillsborough. NQ 27278 <br />Telephone: 919 732 -8181 Ext. 2057 <br />Project Director: Mary Fannina <br />3. Grant Amount Requested: S 10,000 <br />4. Grant Purpose: <br />Development or establishment of a new service <br />X Improvement or expansion of existing services <br />5. Service Area: Orange Count <br />6. Target Population: Day r and 5rhool system-after-school oroarams <br />5 to.13 years old and handicapped youth <br />ORA k- - Co.40" 4-44 As* 'laxr4 +4Dvisoey -coo,,o � /�, <br />695�_� � - %, S r ilk §'T <br />• Signature of Person Authorized to Apply <br />mes ►u1-o'r IT TD. C_+ +R — <br />Title <br />• fj5% o <br />Date <br />DFS 0415 <br />Rev. 5/89 <br />