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Boys & Girls Clubs of Indian River County — Fellsmere Branch Grant Application to the Children's Services Advisory Committee PROGRAM COVER PAGE Organization Name: Boys & Girls Clubs of Indian River County Executive Director: Elizabeth Thomason Address: 1729 17th Avenue Vero Beach, FL 32960 E-maiLethomason@bacirc.org Telephone: (772) 299-7449 Fax: (772) 299-3840 Program Director: Elizabeth Thomason E-mail: same Address: same Telephone: same Fax: same Program Title: Fellsmere Branch Priority Need Area Addressed: #3 Improve and enhance community-based programs that address adolescent's needs, such as: healthy social behaviors positive self esteem, teen pregnancy, delinquency, dropout and substance abuse prevention and other mental and physical health issues. #4 `.Support the programs that enrich a child's learning environment, by offering a curriculum that includes: homework assistance, tutoring, life skills and job readiness training, and other positive youth development programs. Brief Description of the Program: Taxonomy Definition PS -980.1000: Programs that provide a wide range of supervised recreational activities and delinquency prevention services for children and youth of all ages and backgrounds, but particularly for disadvantaged youth through membershi in boys and/or iris clubs. Club members are entitled to use recreational facilities and may have access to counseling, tutorial services, employment assistance, gang programs, drug abuse and alcoholism prevention and other activities and services that direct their energies toward positive social goals and facilitate healthy personality development. SUMMARY REPORT (Enter Information In The Black Cells Only) Amount Requested from Funder for 2014/15: Total Proposed Program Budget for 2014/15: Percent of Total Program Budget: $ $ 10,000.00 339,255.00 2.9% Current Program Funding (2014/15): $ 10,000 Dollar increase/(decrease) in request: $ - Percent increase/(decrease) in request **: 0.0% Unduplicated Number of Children to be served Individually: 300 Unduplicated Number of Adults to be served Individually: - Unduplicated Number to be served via Group settings: - Total Program Cost per Client: 1 1 30.85 **If request increased 5% or more, briefly explain why: n/a. If these funds are being used to match another source, name the source and the $ amount: N/A The Organization's Board of Directors has approved this appli -cn (date). May 2 013 Sherman Hotchkiss � J'1 Name of President/Chair of the Board Signa ure Elizabeth Thomason Name of Executive Director Signatur 2