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Edit this Header. Type the olto Chari te ' and a` °ih nteYand the ht ' ns �` pedQmmite for whom it is being completed <br />. <br /> �L t ,» <br /> The page # is already set at the bottom right of every page. <br /> PROGRAM COVER PAGE <br /> Organization Name : Catholic Charities <br /> Associate Director : Diann 7asinski E-mail : djasinskigcatholiecharitiesdpb . or � <br /> Address : 9995 North Milifqg Trail Telephone : 561 - 775 - 9567 <br /> Palm Beach Gardens , FL 33410 Fax : 561 - 625 - 5906 <br /> Program Director : Tracey Segal E-mail : samcenterl cnibellsouth . net <br /> Address : 3650 41St Street Telephone : 772 - 770 - 3039 <br /> Vero Beach FL 32967 Fax : 772 - 567 - 0812 <br /> Program Title : The Samaritan Center for Homeless Families <br /> Priority Need Area Addressed: The promotion and development of family values and family structure <br /> and the promotion of healthy individuals . <br /> BriefADescription of the Program : The Samaritan Center residential facility for homeless families is a <br /> long-term, transitional program focusing on "Life skills development" (parenting , budgeting , and <br /> education) with the primary goal being the promotion and development of healthy family values and <br /> family structure leading to the successful re- entry into mainstream society . <br /> SUMMARY REPORT — (Enter Information In The Black Cells Only) <br /> Amount Requested from Funder for 2010 / 11 : $ 31 , 500 . 00 <br /> Total Proposed Program Budget for 2010 / 11 : $ 643 , 517 . 08 <br /> Percent of Total Program Budget : 4 . 9 % <br /> Current Program Funding ( 2010 / 11 ) : $ 355000 <br /> Dollar increase / ( decrease ) in request : $ ( 3 , 500 ) <br /> Percent increase / ( decrease ) in request * * : - 10 . 0 % <br /> Unduplicated Number of Children to be served Individually : 58 <br /> Unduplicated Number of Adults to be served Individually : 30 <br /> Unduplicated Number to be served via Group settings : <br /> Total Program Cost per Client : 7312 . 69 <br /> * * If request increased 5 % or more , briefly explain why : <br /> If these funds are being used to match another_ source , name the source and the $ amount_ <br /> Th rga ization 's Board If <br /> Directors has approved. this application on (date) . $` <br /> DI �rm0W( -� zz <br /> Na o President/Chair of the Boar _ Signature <br /> Name of Executive Director/CPO ignature <br /> 2 <br />