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Cover Page P a g e 2 o f 1 1 <br /> <br />COVER PAGE <br /> <br />Applicant Contact Information <br /> <br />Applicant Organization’s Legal Name: Big Brothers Big Sisters of the Triangle, Inc. <br /> <br />Applicant Organization’s Physical Address: 808 Aviation Parkway, Suite 900, Morrisville, NC <br />27560 <br /> <br />Applicant Organization’s Mailing Address: 808 Aviation Parkway, Suite 900, Morrisville, NC <br />27560 <br /> <br />Applicant Organization’s Web Address: www.BigsTri.org <br /> <br />Executive Director: Erin J. Callahan <br /> <br />Telephone Number: (919) 850-9772 E-Mail: ecallahan@bbbstri.org <br /> <br />Tax ID Number: 56-2109717 <br /> <br />Funding Request <br />Please list all Fiscal Year 2023 Human Services (HS) funding requested for all programs and the proposed <br />use of funds (please list program name only) <br />Program Carrboro - HS Chapel Hill - <br />HS <br />Orange <br />County-HS <br />Total <br />Community and Site Based One-to- <br />One Mentoring <br />$5,000 <br />Personnel <br />$5,000 <br />Personnel <br />$10,000 <br />Personnel <br />$20,000 <br /> <br /> <br />Totals $5,000 $5,000 $10,000 $20,000 <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 />Signature: 1/12/2022 <br /> Executive Director Date <br /> Signature: 1/12/2022 <br /> Board Chairperson Date <br />Funds will be used to cover partial cost of enrollment, match, and support program <br />staff. <br />DocuSign Envelope ID: 5F504DF7-674E-4C84-BE84-9F2F9146F185