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STATE AGENCY REQUEST FOR FUNDING FROM INDIAN RIVER COUNTY <br />FISCAL YEAR 2019/2020 <br />A. Program Cover Page <br />Agency: <br />Contact Person: <br />Title: <br />. Address: <br />Website Address: <br />Program Title: <br />I certify that i <br />that the e %a'dit <br />by any o <br />Guardian ad Litem <br />Paul Nigro <br />Circuit Director <br />584 NW University Blvd. <br />Suite 600 <br />Port St. Lucie, FL 34986 <br />vwwd.auardianadlitem.orq <br />Guardian ad Litem <br />Telephone: (772) 785-5804 <br />Fax: (772) 785-5869 <br />E -Mail: paul.nigro(a�gal.fl.gov <br />cc: celia.oarcia(a�gal.fl.gov <br />rmation contained in this application accurately reflects the activities of this agency and <br />res or portionsii eFe:of for which County funds are being requested are not reimbursed <br />rce. <br />Paul Nigro, Circuit Director <br />Signature J Print name and title <br />Brief scription of the Program for which funding is requested: <br />Ttg19th Circuit Guardian ad Litem Program is a partnership of community advocates and professional <br />staff providing a powerful voice on behalf of abused, neglected or abandoned children who are involved in <br />iicourt proceedings in Indian River, Martin, Okeechobee and St. Lucie Counties. <br />Summary Report <br />Amount requested from Indian River County for 2019/2020: <br />Total Proposed Program budget for 2019/2020: <br />Percent of total Program budget: <br />Current Funding (2018/2019) <br />Dollar increase/decrease in request: <br />Percent increase/decrease in request: <br />$137,818.87 <br />$599,212.49 <br />23% <br />$153,804.89 IRC Portion <br />$15,986.02 <br />10.39% <br />If request increased 5% or more, briefly explain why: <br />The Organization's Board of Directors has approved this application on (date): <br />Name of President/Chair of the Board <br />• <br />Name of Exec. Director/CEO <br />69 <br />Signature <br />Signature <br />