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CS8GOR_KPLAN INSTRUCTIONS GENERAL INSTRUCTIONS: Make multiple copies of the WORK PLAN form for completion by the APPLICANT and all potential SUBGRANTEES. Work Plan objectives and activities must correlas with the information provided in the Problems/Solutions section. All work plans must be typed. BE SURE TO COMPLETE AT LEAST ONE PAGE OF THE WORK PROGRAM FOR.EJH PROGRAMAREA THAT IS IDENTIFIED. (items #1 and #2) APPLICANT SUBGRANTEE: Enter the name of the agency,/lrcal government making application in line 11. Enter the name of the subgrantee in line 2 only on the subgrantee's work plan. EACH SUBGRANTEE IS RESPONSIBLE FOR FILLING OUT A SEPARATE WORK PLAN. (Item ;3) PROGRAM AREA - Enter the appropriate Program Area (e.g. Housing, Transportation, Employment, CSBG Program Administration, Food and Nutrition, etc.) that you intend to fund with CS8G monies. IF YOU PLAN TO USE CSBG FUNDS FOR SECONDARY ADMINISTRATIVE EXPENSES", YOU MUST COMPLETE A.SEPARATE PAGE OF THE WORK PLAN FOR EACH PROGRAM WHICH YOU SUPPORT"THROI SECONDARY EXPENSES. The Program Area line must specify. the exact program. Fo r'Example DOE/WEATHERIIATION - SECONDARYADMINISTRATIVE EXPENSES. (Item #4) GEOGRAPHIC AREA TO BE SERVED - Identify specific areas (neighborhood, city, count; etc.) to be served -and impacted by your proposed objective. (item #5) CSBG AMOUNT BUDGETED FOR THIS PROGRAM AREA - indicate amount of CS8G dollars that plan to spend on this program. The sum of ail these amounts should total your Pro ram Budge Total. _ (Item 416) OBJECTIVE(S)-Number each objective. Each objective must state_ a quant flab r. measurable expected result within a specific time frame. Every objective you identify" must relate to the problems or needs you identified in the Problems/Solutions Part of this application Example. Objective #I To secure employment for at least 25 elderly heads of households before March 31, 1983. a (Item #7) ANTICIPATED IMPACT ON POVERTY PROBLEM(S) - Indicate HOW your proposed objective will alleviate the prodFems you identified in t e Problems/Solutions Section. Following the sample objective given above, the Anticipated Impact(s) of that objective might be: Example: I By accomplishing this objective, 25 families will earn enough money to support Chuwiselves. This will result in: (1) having approximately 125 less peraons receiving public assistance in the target area; (2) increas- ing ecopf.unic growth in the community; and (3) increased tax contributions. (Item ,#8) ACTIVITIES - List specific activities you intend to carry out proposed to accomplish your objective. Example: • Activities: 1.1 - I'dentiry and survey private and public employers in the target area to identify vacancies and possi•b+1 on-the-job training employment oppartuhit 1.2.- Develop a master list of employment opportunities. 1.3 - Distribute list to 25 unemployed heads of households per month. (Item 49) STARTING DATE - For each activity, write the exact startinc date. . (Item #10) ENDING DATE- For each activity, write the exact ending date. (Item zlT) FOR DCA USE ONLY _uO.not write in this column. Atli FEB 16 1983 7 .,ct