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COVER PAGE <br />Applicant Contact Information <br />Applicant Organization’s Legal Name:El Centro Hispano,Inc <br />Applicant Organization’s Physical Address:2000 Chapel Hill Road, Durham NC 27707 <br />Applicant Organization’s Mailing Address:2000 Chapel Hill Road, Durham NC 27707 <br />Applicant Organization’s Web Address:www.elcentronc.org <br />Executive Director:Pilar Rocha-Goldberg <br />Telephone Number:(919) 687-4635 Ext. 125 E-Mail:procha@elcentronc.org <br />Tax ID Number:56-2011661 <br />Funding Request <br />Please list all Fiscal Year 2023 Human Services (HS) funding requested for all programs and the <br />proposed use of funds (please list program name only) <br />Program Carrboro - <br />HS <br />Chapel Hill <br />- HS <br />Orange <br />County-HS <br />Total <br />Ex. Youth Afterschool Program <br />Operations or Personnel <br />$10,000 <br />Operations <br />$15,000 <br />Personnel <br />$5,000 <br />Operations <br />$30,000 <br />Carrboro Office Services: Community <br />Support, Adult Education, PreK – 12 <br />Tutoring & Summer Camp (Salaries, rent, <br />supplies, mileage, program materials) <br />$21,450 $47,300 $41,800 $110,550 <br />Totals $21,450 $47,300 $41,800 $110,550 <br />Briefly explain your proposed use of funds: <br />Cover Page Page 5 of 20 <br />DocuSign Envelope ID: AF51EA21-1E75-4247-A4BF-4A60BCBE6049