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DocuSign Envelope ID:6F4743BF-4EA0-4961-AF93-D6509976FC9A <br /> COVER PAGE <br /> Applicant Contact Information <br /> Applicant Organization's Legal Name: Refugee Community Partnership <br /> Applicant Organization's Physical Address: 117 W Main St,Carrboro, NC 27510 <br /> Applicant Organization's Mailing Address: 117 W Main St,Carrboro, NC 27510- <br /> Applicant Organization's Web Address:www.refugeecommunitVpartnership.org <br /> Executive Director: Madison Haves j <br /> Telephone Number: 919-740-5795 E-Mail: madison@rcpteam.org <br /> i <br /> Tax ID Number:26-3608741 <br /> Funding Request <br /> Please list all Fiscal Year 2021 Human Services(HS)funding requested for all programs and the proposed <br /> use of funds(please list program name only) j <br /> Program Carrboro- Chapel Orange Total <br /> HS. Hill-HS County-HS <br /> Ex. Youth AfterschoolProgram $10,000 $15,000 $5,000 $30,000 <br /> Operations or Personnel Operations Personnel Operations <br /> Bridge Builders Program staff salaries;operations $9,000 $20,000 $15,000 $49,000 <br /> Operations Personnel Personnel j <br /> E i <br /> Totals $9,000 $20,000 $15,000 $49,000 f <br /> I I' <br /> Briefly explain your proposed use of funds: <br /> Funds will be used to support program staff salaries;office rent; interpreters for client <br /> communications;and program supplies <br /> I <br /> I I <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: January 12,2020 <br /> Executive Direct Date <br /> Signature: January 12,2020 <br /> Board Chairperson Date <br /> Cover Page Page 6 of 21 <br /> I <br />