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MAIN APPLICATION <br />h.) Program Budget Detail <br />What is the cost to deliver your project/program? List each project/program element in the table <br />below, including the cost of each element, the quantity and unit of measure, and the subtotal for <br />each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. <br />Example Program: Credit Counseling Class <br />Cost Elements <br />Cost($) <br />Quantity /Unit of Measure <br />Subtotal($) <br />Credit Counseling Teacher –in class <br />$25 <br />96 hours (8 hrs/mth x 12 months) <br />$2,400 <br />Credit Counseling Teacher —class prep <br />$25 <br />48 hours (4hrs/mth x 12 mths) <br />$1,200 <br />Credit Counselor — one -on -one <br />$20 <br />120 hours (10 hrs/mth x12 mths <br />$2,400 <br />Materials <br />$25 <br />120 course packets /credit reports <br />$3,000 <br />Total <br />$9,000 <br />Complete the table below for the project /program for which you are requesting <br />funds. Attach additional rows /pages, as needed. <br />Program: Community Education and Civic Engagement (Projected '16- <br />`17) <br />Teens Climb High ** I $41.67 1 2400 (240 students x 10 1 $100,00 <br />Information and Referral 1500 (contacts per yr.) $20,025 <br />$13.35 ,. 9! ,. ---- '- - - -.. Ong AAA <br />Youth Community Education 2740 (1370 people x 2 sessions $36,579 <br />per yr.) <br />Total $189,063 <br />*denotes a rounded average amount <br />* *This program has been and will continue to be fully funded by the state's Dept. of Public Health <br />Define one unit of service: Each Information and Referral Service contact, one attendee at an adult <br />community education presentation (professional or community interpersonal violence education /prevention, <br />agency services, DVAM, WHM), one session of participation in youth interpersonal violence education (Start <br />Strong), each session of participation in adolescent evidence -based sexual health curricula (Teens Climb <br />High). <br />Note: we are no longer counting e- newsletter opens as part of these units of service because we don't <br />believe there is enough educational content to justify this as a service. We are adding Teens Climb High in <br />Main Application 1/24/2016 2:59:42 PM Page 55 of 58 <br />