Laserfiche WebLink
EXHIBIT A <br />AGENCY REQUEST FOR FUNDING FROM'Indian River COUNTY <br />FISCAL YEAR 2019/2020 <br />A. Program Cover Page <br />Agency: 211 Palm Beach/Treasure Coast, Inc. <br />Contact Person: Sharon L'Herrou <br />Title: President/CEO <br />Address: P.O. Box 3588 <br />Lantana, FL 33465-3588 <br />Website Address: www.211 treasurecoast.org <br />Program Title: 211 HelpLine <br />Telephone: 561-533-1065 <br />Fax: 561-547-8639 <br />E -Mail: sharon@211 pbtc.org <br />I certify that information contained in this application accurately reflects the activities of this agency and <br />that the expenditures or portions thereof for which County funds are being requested are not reimbursed <br />by an other source. <br />v (4Sharon L'Herrou President/CEO <br />Signature Print name and title <br />wrier aescnption of the Program for which funding is requested: <br />211 HelpLine is the crisis hotline and community helpline serving individuals and families in Indian River <br />County who are struggling with life's challenges and need someone to talk to, someone who cares, and <br />someone who can connect them with the services they so desperately need. 211 HelpLine operates 24 <br />hours per day/365 days per year, providing technology based services consisting of information, <br />assessment, referral, advocacy, and follow-up, along with crisis intervention, suicide prevention, and <br />emergency counseling. Highly trained Resource Center Specialists are non -judgmental, exhibit active <br />listening skills, and utilize a comprehensive Health and Human Services Database to make appropriate <br />referrals based on callers' requests and inquiries. 211 HelpLine is also the regional responder for the <br />National Suicide Prevention Lifeline, meaning that anyone in the Treasure Coast that dials the 1 -800 -273 - <br />TALK number, reaches our trained staff who are able to de-escalate suicidal callers. Our staff save lives, <br />every single day! <br />Ouuunary rtepvr[ <br />Amount requested from Indian River County for 2019/2020: $ 10,767 <br />Total Proposed Program budget for 2019/2020: $ 522,762 <br />Percent of total Program budget: 2.06% <br />Current Funding (2018/2019) $ 10,453 <br />Dollar increase / (decrease) in request: $ 314 <br />Percent increase / decrease in request: 3% <br />n iCyuCat iiwiGaseu o -/o ui muie, uneny explain wn : <br />N/A <br />The Organization's Board of Directors has approved this application on <br />John Deese <br />Name of President/Chair of the Board <br />_ Sharon L'Herrou <br />Name of Exec. Director/CEO <br />Signatur <br />Signature <br />EXHIBIT A <br />019 <br />F£,µ <br />a <br />�q <br />