Laserfiche WebLink
FLORIDA SI:iANCII. ',S:�iS:'AN' . �:R CC:".':U;iT__TSERVICES ACT O 1974 <br />(CO'%iMU21iT'_' SERV=OS =:?US'." Fno) <br />G71LANT APPLIC_.TI0:7 Page 1 0,-". 7 <br />tiIAIL TO: <br />Earl Billings <br />Department of Veteran, and <br />Community A`rairE <br />2571 Executive Cantar Circle Eas t <br />Tallahassee, F1. <br />32301 <br />* Submit an O_ig4_nal Coo <br />* <br />PLEASE TYPE - ANS::r'R y <br />QUESTIOtis <br />1. Local Governmental Unit Acolying for Grant: <br />Board of County Commissioners of <br />Name: Indian River County, Florida Teleahcre: (305)562-13000 <br />name of town, city or county) <br />Address: 1840 25th Street, Suite N158 Zi 0 ; 32960 <br />County: Indian River County <br />2. Delegate Agency (s) : Mental Health Association <br />(applicable only for private non profit corporation delegates) <br />s. Person with over-all responsibility of grant: Our Depart=ent will <br />contact this person should questions mise <br />Namis: Jane 14. Baldwin, Director Telephone: (305) 562-5713 <br />Address: 1020 21st Street P.O. Box 427 Vero Beach, Florida 32960 <br />Signature: <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 chec} <br />will be made payable to t1he local government. <br />Name: Jeff Barton, Finance Director <br />n ian River County <br />Address: 1840 25th Street - <br />Vero Beach, Florida Zip: 32960 <br />NOTE: TLi7S APPLICATION MUST FF POSTMARKED NO LATER TEIAN <br />FEBRUARY 1, 1982 IN-OP.DFR TO BE CONSIDERED. <br />