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Cover Page P a g e 6 o f 2 3 <br />COVER PAGE <br /> <br />Applicant Contact Information <br /> <br />A Helping Hand <br /> <br />1502 West NC Highway 54, Suite 405 Durham, NC 27707 <br /> <br />1502 West NC Highway 54, Suite 405 Durham, NC 27707 <br /> <br />www.ahelpinghandnc.org <br /> <br />Executive Director: Jennifer Ashley <br /> <br />Telephone Number: 919-403-5555 E-Mail: Jennifer.Ashley@ahelpinghandnc.org <br /> <br />Tax ID Number: 56-1923835 <br /> <br />Funding Request <br /> <br />Please list all Fiscal Year 2022 Human Services (HS) funding requested for all programs and the proposed <br />use of funds (please list program name only) <br />Program Carrboro - <br />HS <br />Chapel <br />Hill - HS <br />Orange <br />County-HS <br />Total <br />Pre-Health Internship Program <br />Operations or Personnel <br />$5,000 <br />Personnel <br />$6,000 <br />Personnel <br />$5,000 <br />Personnel <br />$16,000 <br /> <br /> <br />Totals $5,000 $6,000 $5,000 $16,000 <br /> <br />Briefly explain your proposed use of funds: <br /> <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 /> <br /> <br />Signature: <br /> Executive Director Date <br /> <br /> <br />Signature: <br /> Board Chairperson Date <br />An internship program focused on preparing future practitioners for an increase in the local & <br />national geriatric population. A primary goal of this program is to provide exposure and <br />meaningful interaction that will result in these future professionals viewing older adults as <br />people and not just patients. Additionally, interns who participate in this program develop a <br />more intimate connection to their community and a nuanced understanding of the root causes of <br />their clients conditions. <br />January 10, 2020 <br />January 10, 2020 <br />DocuSign Envelope ID: 9B1DC55D-94EA-40F5-BA24-B9B5CF170083