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I <br />FLORIDA FINANCIAL 1.33ISTANCE i 0R COMMUNITY SERI,' iP'ES ACT OF 1974 <br />(COP".MUNITY SERVICES TRUST FUND) <br />GRANT APPLICATION Page 1 of 7 <br />MAIL TO: <br />Earl Billings <br />Department of Veteran and <br />Community Affairs <br />2571 Executive Center Circle East <br />Tallahassee, F1. <br />32301 <br />1. Local Governmental Unit Applying for Grant: <br />* Submit an Original Copy <br />* PLEASE TYPE - AtiS."ER ALL <br />QUESTIONS <br />Name: INDIAN RIVER COUNTY Telephone • (305) 562-4186 <br />(name of town, city or county) <br />Address • 2Co4un y-Courioude, Vero Beach, Florida zip: 32960 <br />County: Indian River County <br />2 . <br />Delegate Agency (s) : Indian River County Council on Aging, Inc. <br />(applicable only for private non profa.t corporationa egates) <br />3. Person with over-all responsibility of grant: Our' Department will <br />contact this person should questions arise <br />.Name: Judith N. Welchel Telephone: _305-569-0760 <br />Address. 955 7th.Avenue, Vero Beach, Florida 32960 <br />Signature: <br />a <br />4. Name and address of person authorized to receive funds. If this ap- <br />plication is funded, checks will be mailed to this person. All checks <br />will be made payable to the local government. <br />Name: L. S. "Tommy" Thomas Intergovernmental Coordinator, Indian River County <br />Address: Room 115 - County Courthouse, Vero Beach, Florida 32960 <br />zip: 32960 <br />A U G - 5 1981 <br />BOX �� PAGE <br />�� <br />