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GR -':T APPLICATION Page 5 of 7 <br />r" <br />l 1 <br />Gc.e_ zrent Unit Applying: `-- L -legate Age.,ic*�.•'�.i <br />- <br />w <br />ca <br />a. <br />CASH AND IN-KIND MATC:: � <br />�. Cash Patch <br />ac <br />0 <br />c� <br />cr, <br />Source Amou-it <br />1. I �o �ou::da�io; 1. 1573.25 <br />2. 2- <br />3. 3. <br />4. 4. I. TOTAL CAsii i•'ATCH 1573.25 <br />Salaries and Benefits NL:-nber of Hours Tota? (z?ot rIv rate num- <br />-Ti--Ie asci 'lame of Person ':purl' .ate To Be S'+or`---d ber hours to be worked <br />1. H,;:7eT-�ker Vzoiin eer 1. ,10 1. 252 1. 331,20 <br />J <br />olunteer 2. _ iC 2. _ 255 2- 3-:2.05 <br />3. F 3. 3. 3. <br />4. 4. 4. 4. <br />II. TOT.•.L SALARIES 1573.25 <br />o --her In -Vinci Total (Unit cost x num- <br />):>r ri-}tion an' -1 Source "Jnt cst Nc-f Un_ts ber of un�ts' <br />2. 2. 2. 2. <br />3. 3. 3. CO <br />J - <br />�, 4 . 4. 4. <br />t . tet" <br />III . TOW.L OT: -ER _0- <br />CD <br />