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COVER PAGE <br />Applicant Contact Information <br />Applicant Organization’s Legal Name:Chapel Hill-Carrboro Children’s Museum <br />Applicant Organization’s Physical Address:201 S.Estes Drive, Ste. A9, Chapel Hill, <br />NC 27514 <br />Applicant Organization’s Mailing Address:201 S. Estes Drive, Ste. A9, Chapel Hill, NC <br />27514 <br />Applicant Organization’s Web Address:www.kidzuchildrensmuseum.org <br />Executive Director:Jamie DeMent Holcomb <br />Telephone Number:919-933-1455 E-Mail:jamie@kidzuchildrensmuseum.org <br />Tax ID Number:20-2058235 <br />Funding Request <br />Please list all Fiscal Year 2024 Human Services (HS) funding requested for all <br />programs and the proposed use of funds (please list program name only) <br />Program Carrbor <br />o - HS <br />Chapel <br />Hill - <br />HS <br />Orange <br />County-H <br />S <br />Total <br />Ex. Youth Afterschool Program <br />Operations or Personnel <br />$10,000 <br />Operati <br />ons <br />$15,00 <br />0 <br />Person <br />nel <br />$5,000 <br />Operatio <br />ns <br />$30,000 <br />Adaptive Playdates for Town of Chapel Hill <br />families <br />$6,550 <br />Progra <br />m <br />Operati <br />ons + <br />Person <br />nel <br />$6,550 <br />Kidzu for All $30,578 <br />Program <br />Operation <br />s + <br />Supplies <br />+ <br />Personnel <br />$30,578 <br />Adaptive Playdates for Carrboro families $5,000 <br />Program <br />Operatio <br />$5,000 <br />Cover Page Page 7 of 31 <br />DocuSign Envelope ID: 9F73F5ED-FE40-4DB1-BBAD-AF773010D285