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1. COVER PAGE <br />a)Applicant Contact Information <br />Applicant Organization’s Legal Name: Movement of Youth, Incorporated <br />Applicant Organization’s Physical Address: 406 Blackwell Street, Suite B030, Durham, NC <br />27701 <br />Applicant Organization’s Mailing Address: Same as above <br />Applicant Organization’s Web Address: www.movementofyouth.org <br />Executive Director: Atrayus Goode <br />Telephone Number:(800) 956-3820E-Mail:agoode@movementofyouth.org <br />Tax IDNumber: 26-2399990 <br />b)Funding Request <br />List all FY18-19Human Services(HS)Funding Being Requested – <br />For All Programs)and the Proposed Use of Funds (2-3 lines or less) <br />Program Carrboro <br />-HS <br />Chapel <br />Hill-HS <br />Orange <br />County-HS <br />Total <br />MBK Spring Break College Tour.Travel and <br />Lodging for 50 students from MBK-related agencies <br />26,250.00 26,250.00 <br />MBK Saturday Leadership Academy & Team <br />Mentoring.Cost for 50 students from MBK-related <br />agencies to receive comprehensive Saturday <br />Leadership Academy that focuses on mastery of 21st <br />Century Skills and Team Mentoring that focuses on <br />life skills and character development. <br />12,736.00 12,736.00 <br />MBK Opportunity Summits.Cost for supplies, food, <br />presenters, and materials for two (2) MBK Opportunity <br />Summitsfor high school students, college students, K- <br />12 educators, and community and business leaders. <br />Summits will focus on student achievement, <br />career/personal/professional development, social <br />justice and engagement, and mentorship. <br />10,000.00 10,000.00 <br />Mentoring&YouthProgramDevelopment.Cost for <br />technical assistance to support MBK-related agencies, <br />including in-person staff training workshops, training <br />facilitation (mentor/mentee/parents), and baseline <br />data assessments to help these programs incorporate <br />or enhance quality youthdevelopment practices that <br />lead to long term sustainability. <br />40,000.00 40,000.00 <br />EXHIBIT A: Provider's Outside Agency Application <br />DocuSign Envelope ID: 7399BACD-0CBF-4EF4-9068-B429A8CA12F8