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ORGANIZATION: GIFFORD YOUTH ACTIVITY CENTER/MENTAL HEALTH ASSOCIATION <br /> PROGRAM: MENTAL HEALTH SERVICES FOR CHILDREN & FAMILIES <br /> FUNDER: CHILDREN'S SERVICES ADVISORY COMMITTEE <br /> PROGRAM COVER PAGE <br /> Organization Name: Gifford Youth Activity Center <br /> Executive Director: Michael S. Hubler E-mail: mhublerW yvac . cc <br /> Address: 4875 43rd Avenue Telephone_ (772) 794- 1005 <br /> Vero Beach, FL 32967 Fax: (772) 569-5563 <br /> Program Director: Michael Williams E-mail : mwilliams &gyac .cc <br /> Address: 4875 43`d Avenue Telephone : (772) 794- 1005 <br /> Vero Beach, FL 32967 Fax: (772) 569-5563 <br /> Program Title: Mental Health Services for Children & Families <br /> Priority Need Area Addressed: Mental wellness issues for children preschool to age 18 and <br /> parental support and education. <br /> Brief Description of the Program: The Mental Health Services Program is desiPated to offer individual <br /> and group services to preschoolers, elementary school children teens and parents to assist youth to <br /> improve the emotional and behavioral problems which are negatively impacting their ability for <br /> personal growth, development and academic achievements. Taxonomy Definition — Mental Health <br /> Care and Counseling. <br /> SUMMARY REPORT — (Enter Information In The Black Cells Onl <br /> Amount Requested from Funder for 2006 /07 : $ 605673 . 96 <br /> Total Proposed Program Budget for 2006 /07 : $ 763815 . 26 <br /> Percent of Total Program Budget : 79 . 0 % <br /> Current Program Funding (2005 /06 ) : $ _ <br /> Dollar increase/( decrease ) in request : $ 60 , 674 <br /> Percent increase/(decrease) in request * * # DIV ; O ! <br /> Unduplicated Number of Children to be served Individually : 75 <br /> Unduplicated Number of Adults to be served Individually : 60 <br /> Unduplicated Number to be served via Group settings : 60 <br /> Total Program Cost per Client : 393 . 92 <br /> * *If request increased 5 % or more, briefly explain why: <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 (date). UA <br /> John H. Dean <br /> Name of President/Chair of the Board <igPnagRf <br /> Michael S. Hubler I <br /> Name of Executive Director/CEO Signature <br /> 3 <br />