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DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 <br /> 1. COVER PAGE <br /> a) Applicant Contact Information <br /> Applicant Organization's Legal Name: Inter-Faith Council For Social. Service <br /> Applicant Organization's Physical Address: 110 W. Main Street, Carrboro, NC 27510 <br /> Applicant Organization's Mailing Address: 110 W. Main Street Carrboro NC 27510 <br /> Applicant Organization's Web Address: http://www.ifcweb.org <br /> Executive director: Jackie,leaks <br /> Telephone Number: 919-929-5380x14 E-Mail.iienks(ztifcmaJbox.org <br /> Tax ID Number: 59-1224041 <br /> b) Funding Request <br /> List all FY18-19 Human Services fHS] Funding Being Requested— <br /> For All Programs) and the Proposed Use of Funds (2-3 lines or less) <br /> Program am Carrboros Chapel Orange Total <br /> -HS Hill-HS County-HS <br /> Food For the Summer $1,500 $1,500 $1,500 $4,500 <br /> Teen Ambassador program, Middle School Pilot <br /> program and materials <br /> Totals <br /> c) To the best of my knowledge and belief all information and data in this application is <br /> true and current. The document has been duly authorized by the governing board of the <br /> applicant. <br /> Signature: <br /> Executive Director Date <br /> Signature: <br /> Beard Chairperson Date <br /> ............ .. .... <br /> AGENCY INFORMATION 1/2312038 12:16:05 PM Page 8 of 26 <br />