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ORANGE COUNTY <br /> NORTH CAROLINA <br /> Applicant Organization & Collaborator Information <br /> Please provide the following information about the primary applicant organization: <br /> 1. Date of Incorporation (Month/Year): <br /> 2. Applicant organization's Purpose/Mission (no more than 2-4 sentences): <br /> 3. Please provide a brief description of your organization's past achievements in carrying out similar <br /> projects and evidence of successful record of meeting proposed budgets and timetables (no more <br /> than 2-4 sentences). <br /> 4. Living Wage: Does this organization pay permanent employees a minimum living wage? (Yes/No) <br /> If yes, is this organization an Orange County Living Wage Certified Employer? <br /> If no, please briefly explain. <br /> S. Schedule of Positions: <br /> a. Number of Full-Time Paid Positons: <br /> b. Number of Part-Time Paid Positions: <br /> c. Number of volunteers_and average hours worked per volunteer per month <br /> Please provide the following information about all significant collaborators and partners whether or <br /> not they will be receiving grant funding for this project. Feel free to copy and paste Questions "a" <br /> through"e" as needed if you have more than one significant collaborator/partner: <br /> a) Date of Incorporation (Month/Year): <br /> b) Applicant organization's Purpose/Mission (no more than a few sentences): <br /> c) Please provide a brief description of your organization's past achievements in carrying out <br /> similar projects and evidence of successful record of meeting proposed budgets and <br /> timetables (no more than 100 words). <br /> P.O. Box 8181 * Hillsborough, North Carolina 27278 <br /> Telephone:919 245-2626 <br />