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The Center for Emotional and Behavioral Health - Camp Manatee Therapeutic Summer Camp — IRC- CSAC <br /> PROGRAM COVER PAGE <br /> Organization Name : The Center for Emotional & Behavioral Health (aJ IItNIH <br /> Executive Director : Dr. Raymond Dean MD Email : rdean@irmh. com <br /> Address : 1190 37"' Street Vero Beach FL 32960 Telephone : 772- 563 -4666 ext 1809 <br /> Fax : 772- 770-2025 <br /> Program Director: Mariamma Pyngolil, RN Email : mpyngolil@irmh . com <br /> Address : 1190 37th Street Vero Beach FL 32960 Telephone : 772- 563 -4666 ext 1838 <br /> Fax : 772- 770-2025 <br /> Program Title : Camp Manatee Therapeutic Camp <br /> Priority Need Area Addressed: Therapeutic, intervention and educational program for children <br /> diagnosed with ADHD and other more severe emotional problems in Indian River County <br /> Brief Description of the Program : _ Day camp facility that is appropriately staffed and equipped <br /> to provide an opportunity for children who have developmental disabilities, emotional <br /> disturbances, and/or health impairments who have other limitations or problems which require <br /> special facilities or programminl7 to enjoy a cooperative living experience in the out of doors <br /> Amount Requested from Funder for 2003 / 04 : 24 , 500 . 00 <br /> Total Proposed Program Budget for 2003 /04 : $ 545500 <br /> Percent of Total Program Budget : 45 . 0 % <br /> Current Funding ( 2002 /03 ) : $ 207000 <br /> Dollar increase/( decrease) in request : $ 4 , 500 <br /> Percent increase/( decrease) in request : 22 . 5 % <br /> Unduplicated Number of Children to be served Individually : 43 <br /> Unduplicated Number of Adults to be served Individually : _ <br /> Unduplicated Number to be served via Group settings : _ <br /> Total Program Cost per Client : 1267 . 44 <br /> Will these funds be used to match another source ? No <br /> If yes , name the source : <br /> Amount : $ _ <br /> The Organization s Board ofDirectons has approved this application on (date). WY <br /> Name of Pr i ent of the Board <br /> Name of Ex ti <br /> Director Signature <br /> I�a y M0A N D-eQ q <br /> 3 <br />