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DocuSign Envelope ID:7E3AF63A-2F47-4028-951A-OOBA2A7COOB2 - <br /> COVER PAGE <br /> Applicant Contact Information <br /> Applicant Organization's Legal Name: Inter-Faith Council for Social Service <br /> Applicant Organization's Physical Address: 110 West Main Street Carrboro NC 27510 <br /> Applicant Organization's Mailing Address: 110 West Main Street, Carrboro, NC 27510 <br /> Applicant Organization's Web Address:www.ifcweb.or <br /> Executive Director:Jackie Jenks <br /> Telephone Number:(919) 929-6380 x14 E-Mail: lienks(Wornailbox_om <br /> Tax ID Number:59-1224041 <br /> Funding Request <br /> Please list all Fiscal Year 2020 Human Services(HS)funding requested for all programs and the <br /> proposed use of funds(please list program mime only) <br /> Program Carrboro- Chapel Orange Total <br /> HS Hill-H5 County-HS <br /> Residential Services: $5,000 $2.5,000 $35,000 $65,000 <br /> HomeStart, shelter for women and families <br /> Communi House, shelter for men <br /> Food Security Programs: $10,000 $25,000 $35,000 $70,000 <br /> Food Pantry <br /> Communi Kitchen <br /> Totals $15,000 $50,000 $70,000 $135,000 <br /> To the best of my knowledge and belief all information and data in this application is true and <br /> current. The document has been duly authorized by the governing board of the applicant. <br /> Signature: V t� r 11 <br /> Executive Director Date <br /> Z <br /> Signature: (2ZI j 2 2 1 <br /> oar Chairperson Date <br /> Cover'Page P a g e S 0 F 2 5 <br />