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Edit this Header. Type the organization and program name and the funder for whom it is being completed . The page # is already set <br /> at the bottom right <br /> of every page. <br /> Y. <br /> rF <br /> PROGRAM COVERAGE <br /> RWRTyf '4 z w�.. ^ i p x, `�." 'y1 ; i * •'. ' 1 rry <br /> M <br /> "tY 1 ! AM,,' orl lVol a va >< p �n4� �M ,sr ; � <br /> ibkl's'.QirLr Y✓R. -PR�.rF,i4.!!' ha..*M. xl r w.7i Fr«::'u •y,K,,.iw:. . ..... a <br /> Executive Director: Henry Burson, Jr. Email : Brotherpreach@aol . com <br /> Address : 4545 38th Ave Telephone : 772 -770- 5759 <br /> Vero Beach, Fl 32967 Fax : 772- 562- 6965 <br /> Program Director: Hallicurtis W . Burson E-mail : hope- cad@bellsouth . net <br /> Address : 4545 38th Avenue Telephone : 772 - 562 -4325 <br /> Vero Beach, Florida 32967 Fax : 772- 562- 6965 <br /> Nat <br /> i ,...._ <br /> Fr �791Ne'±!ma+C <br /> Y :, <br /> • a <br /> _ s '� .. Sys • <br /> Hort ' Need Area Addressed: Paren al Support and education <br /> Brief Description of the Program : CSC Taxonomy Code HD - 050 <br /> HOPE Academy focuses on treating special problem for children ages 7 - 18 . We also have a <br /> Family component ; a monthly 2hr. seminar that address parental empowerment . <br /> i <br /> iff <br /> B1ff1!k`Ce11sOn1 r f, <br /> . _ .e w.ter:'Az :x,*�..., <br /> o a Vroposed Program Budget for 2004 / 05 : $ 201 , 590 . 32 <br /> Percent of Total Program Budget : 64 . 0 % <br /> Current Program Funding ( 2003 / 04 ) : $ 100 , 000 <br /> Dollar increase / ( decrease ) in request : $ 28 , 976 <br /> Percent increase / ( decrease ) in request * * : 29 . 0 % <br /> Unduplicated Number of Children to be served Individually : 482 <br /> Unduplicated Number of Adults to be served Individually : - <br /> Unduplicated Number to be served via Group settings : 212 <br /> Total Program Cost per Client : 290 . 48 <br /> * *If request increased 5 % or more, briefly explain why: We are serving more clients each year. <br /> This years total is up over last. If form holds true , we will see at least an additional 100 clients this <br /> Year <br /> If these funds are being used to match another source, name the source and the $ amount : <br /> The Organization 's Board of Directors has approved this application on 2002004 <br /> _Henry Burson, Jr. k <br /> Name of President/Chair of the Board Sign <br /> _Hallicurtis W . Burson <br /> Name of Executive Director/CEO Sj, n ture <br /> . 3 <br />