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Boys & Girls Club of Indian River County, Inc. — South Countv Branch <br /> Grant Application to the Children ' s Services Advisory Committee <br /> PROGRAM COVER PAGE <br /> Organization Name : Boys & Girls Clubs of Indian River County, Inc . <br /> Executive Director : Leisa Smith-Fulton Email : LeisaSmith@,,juno . com <br /> Address : P . O . Box 3058 Telephone : (772) 299-7449 <br /> Vero Beach, FL 32964 Fax : (772 ) 299- 3840 <br /> Program Director: Tony Ross Email : mrross001@hotmaii . com <br /> Address : P . O . Box 3068 Telephone : (722 ) 299- 7494 <br /> Vero Beach, FL 32964 Fax : (772 ) 794- 3903 <br /> Program Title : South County Branch <br /> Priority Need Area Addressed: Mental Wellness Issues & Childcare Access <br /> Brief Description of the Program : Taxonomy Definition for Boys/Girls Clubs - PS - 980 . 1 <br /> Proerarns that provide a wide tame of supervised regional activities and ddinquency prevention services for children <br /> and youth ofall a= and backwp In s _bit particularly for disadvarlta d vouch through membership in boys and/or wris <br /> clubs. Club members are wed to use regional facilities and may have access to cot ulseling tutorial services <br /> employment assistance, ming progams, drag abuse and alcoholism preverrtion and other acm'j ies and services that direct <br /> than enemies toward positive social goals and facilitate healthy petro '—V development <br /> Amount Requested from Funder for 2003 /04 : S 30 , 000 <br /> Total Proposed Program Budget for 2003 / 04 : S 152 , 405 <br /> Percent of Total Program Budget : 19 . 7 % <br /> Current Funding (2002 /03 ) : $ 30 , 000 <br /> Dollar increase/( decrease) in request : S _ <br /> Percent increase/ ( decrease ) in request : 0 . 0 % <br /> Unduplicated Number of Children to be served Individually : 375 <br /> Unduplicated Number of Adults to be served Individually : 100 <br /> Unduplicated Number to be served via Group settings : 420 <br /> Total Program Cost per Client : 170 . 28 <br /> Will these funds be used to match another source ? No <br /> If yes , name the source : <br /> Amount : <br /> S - <br /> The Organization 's Board of Directors has approved this application o te) . 5 - 14-2003 <br /> Jav McNamara - } <br /> Z L <br /> Name of President/Chair of the Board Signature <br /> Leisa Smith-Fulton <br /> Name of Executive Director/CEO Signature <br />