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G EN ER~.%L I[NFO R,', IATION <br /> <br />Name o£ Organization: 4-H <br />Street Address: <br /> <br />Oily: Concor~ <br /> <br />2001 PH£1_ P A40 _r$ EA, IPLOYEE CO/I,f,,HL/N£TY FL'ND <br /> <br />SOS <br /> <br /> Box 387 <br /> <br /> State: NC Zip Code: 28026 <br /> <br />Pamela C. Outen, 4-H Family & Consumer Agent <br /> <br />Ext. <br /> <br />Web address: <br /> <br />Fax: 704-792-0539 <br /> <br />Name & Title of Contact for this Proposal: <br /> <br />Office Telel~hone: 704-920-3310 <br /> <br />Email: PamelaOuten@ncsu. edu <br /> <br />Amt. Requested: $%6,73{) Project Budget: .$60t. 110 TotaIOrg. Bodget: $194,178 <br /> <br />Please indicate thc Focus Area for which yon are applying for funding: O~ou may only apply for one) <br /> <br />[3Domestic Violence CIEmergency Services ElHunger Relief llSenior Services KlYouth <br /> <br />Co m m unities/Cou nties Served: ~" j h r3 r r.-11 q r'n,mey <br /> <br />P/T: ] g Volunteers: 41 <br />2000 Actual ] ] 0 2001 Estimated ] 30 <br /> <br />2000 Actual 1 4 2001 Estimated 3 6 <br /> <br />Number of Paid Staff: l 8 F/T: <br /> <br />INumbers served by org~,,iz-'~tion: 1999 Actual R ? <br /> <br />Nh,abets served by proposed project: 1999 Actual 0 <br /> <br />Describethemai. mi~sion& populationyourorgani~tionse~es: <br /> <br />The 4-U SOt Goldminers program provides students at Concord Middle, <br />Mt. Pleasant Middle and JN Fries Middle Schools with an intensively <br /> <br />planned program which targets "latchkey" children and those who <br />benefit from close interaction with caring adults. <br /> <br />would <br /> <br />Pleaseprovideal-2scntencedeseriptionofthisrequ~t, includingtheprojectname: <br /> <br />Th~ ~-R SO~ G~]dm~nors program prnu~dos care for a population who frequently <br />are unsupervised durinq the critical afterschool hours. A definite <br /> <br />hood to 6ontinue the proqram has been identified by school administration <br />and parents <br /> <br />I ccrt~, that the i,~fornmtion provhled fit thA' application ia' true to the best of my knowledge. Date <br /> <br />ExccutiveDireclor pamela C. Oaten <br />PRIN'F SIGN <br /> <br />Board Chair 3ud¥ Furr <br /> PR~'V S~GN <br /> <br />PHiLiP MORRIS E~V, PLO¥'EE COU~vlUNITY FUND 2001 GRANT APPLICATION PAGE I OF 5 <br /> <br /> <br />