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]) Con[act Person: Eater the name, address and telephoee aumher <br /> of the person who %s responsible for the programmatic and fisca! <br /> administration of the program. <br /> <br /> 4) Referrer Sources: Eater the agencies from which referrers will <br /> be received by the program. (Juvenile Court must be listed by all <br /> CRA funded programs) <br /> <br /> To the right of Items 2, 3 and 4 above list: <br /> <br /> l) Couety: for multi'county programs list the county which ls <br /> submitting the Program Agreement. <br /> <br /> 2) Program Type: Refer to the attached Glossary for definition <br /> of program types funded by CBA. <br /> <br /> 3) Funding Period: Must fall within the t2 ~onth fiscal year <br /> for which the funds are appropriated. Beginning date may <br /> be anytime after July 1st, ending date may not be later than <br /> June 30th. <br /> <br /> 4} CBA Assigned I.D.S: Check with CBA Regional Office if there <br /> are' questions on this. For new programs an I.D.D will be <br /> assigned. <br /> <br /> 5) New Pro,ram: Check here if this is the first year of CBA <br /> funding. <br /> <br /> 6) Continuation Program: Check here if this program ~s currently <br /> receiving CBA funding. <br /> <br /> 5) Client Capacity: The number of youth the program ~s designed <br /> to serve at any one time. <br /> <br /> 6)Average Length of Stay: Enter the ~onths or days that ~he program <br /> · s designed 5o provide services to the average client. <br /> <br /> 7) Number of Youth to be Served: During the funding per~od shown <br /> above how many youth do you estimate will be served by this program. <br /> <br />'If the funds being requested will be used to support more than one program <br />component, please provide client capacity, length of stay and estimated <br /> number of youth to be served for each component. Use a separate sheet If ~ec- <br /> essary. <br /> <br /> 26b <br /> <br /> <br />