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DocuSign Envelope ID:29B34BCC-1A11-40B3-9EE7-168E6261E415 <br /> COVER PAGE <br /> Applicant Contact Information <br /> Applicant Organization's Legal Name: Pathways to Change <br /> Applicant Organization's Physical Address: 960 Corporate Dr. Suite 408, Hillsborough, NC 27278 <br /> Applicant Organization's Mailing Address: 960 Corporate Dr. Suite 408, Hillsborough, NC 27278 <br /> Applicant Organization's web Address: www.pathwaystochangenc.org <br /> Executive Director: John Williamson <br /> Telephone Number: 919-245-3309 E-Mail: john(c�pathwaystochangenc.org <br /> Tax ID Number: 58-2063924 <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) <br /> Program Carrboro- Chapel Hill- Orange Total <br /> HS HS County-HS <br /> Ex. Youth Afterschool Program $10,000 $15,000 $5,000 $30,000 <br /> Operations or Personnel Operations Personnel Operations <br /> Partner Abuse Intervention $2137.00 $5734.00 $12,386.00 <br /> Personnel Personnel <br /> $2,300.00 $2215.00 <br /> Operations Operations <br /> Partner Abuse Intervention (Female Group) $2137.00 $4351.00 <br /> Personnel <br /> $2214.00 <br /> Operations <br /> Anger Management $845.00 $2538.00 $6067.00 <br /> Personnel Personnel <br /> 695.00 $1989.00 <br /> Operations Operations <br /> $12,Strong Fathers $3238.00 $1807.00 $9198.00 <br /> Personnel Personnel <br /> $2201.00 $1952.00 <br /> Operations Operations <br /> Totals $1540.00 $9876.00 $20,586.00 $32.002.00 <br /> Cover Page <br />