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1/16/24, 2:02 PM HSOA-24-49 <br />https://chapelhillnc.workflow.opengov.com/#/explore/records/62830/297526 1/14 <br />Town of Chapel Hill, NC 1/16/2024 <br />HSOA-24-49 <br />Human Services/Outside Agencies <br />Funding Application Fiscal Year 2025 <br />Status: Active <br />Submitted On: 1/12/2024 <br />Applicant <br />Lynn Garrett <br />612-327-0883 <br />lynn.garrett@swimforcharlie.org <br />714 Lorentello Circle <br />Hillsborough, NC 27278 <br />Agency Information <br />Agency's Legal Name <br />Dr. Charles van der Horst Water Safety <br />Initiative <br />Agency's Mailing Address (Street, City, State & Zip <br />Code) <br />1821 Hillandale Road, Suite 1B #126, <br />Durham, NC 27705 <br />Agency's Physical Address (Street, City, State & Zip <br />Code) <br />6730 Creek Wood Drive, Chapel Hill, NC <br />27514 <br />Agency’s Web Address <br />https://swimforcharlie.org <br />Tax ID: <br />**-***7052 <br />Date of Incorporation (Month/Year) <br />August 2019 <br />Executive Director Name <br />Dr. Jonathan E. Klein <br />E-Mail Address <br />jonathan.klein@swimforcharlie.org <br />Telephone Number <br />919-260-0089 <br />Docusign Envelope ID: 24B21284-4C91-400A-B5A9-0EAB830F7C32