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ORGANIZATION : GIFFORD YOUTH ACTIVITY CENTER, INC . <br /> PROGRAM : YOUTH AND FAMILY GUIDANCE PROGRAM <br /> FUNDER : CHILDREN ' S SERVICES ADVISORY COMMITTEE <br /> r <br /> PROGRAM COVER PAGE <br /> Organization Name : Gifford Youth Activity Center, Inc . ( GYAC ) <br /> Executive Director : Angelia Perry E -mail : aperryLa gyac . cc <br /> Address : 4875 43 `d Avenue Telephone : ( 772 ) 794 - 1005 ext . 22 <br /> Vero Beach, FL 32967 Fax : ( 772 ) 569 - 5563 <br /> Program Director : Dr . Joe Hannam E -mail : ihannam (a] gyac . cc <br /> Address : 4875 43 `d Avenue Telephone : ( 772 ) 794 - 1005 ext . 30 <br /> Vero Beach , FL 32967 Fax : (772 ) 569 - 5563 <br /> Program Title : Youth and Family Guidance Program -- <br /> Priority Need Area Addressed: Mental Health <br /> Brief Description of the Program : The Youth and Family Guidance Program will provide on- site <br /> counseling services to at- risk students and their families for the purpose of addressing emotional , <br /> behavioral , and academic problems that may impede the academic success of the students we serve . <br /> SUMMARY REPORT — Enter Information In The Black Cells Only) <br /> Amount Requested from Funder for2008 / 09 : S 25 , 000 . 00 , --- <br /> Total Proposed Program Budget for 2008 / 09 : S 505778 . 00 <br /> PercentofTotal Program Budget : 49 . 2 % <br /> C urrent Program Funding ( 2007 / 08 ) : $ - <br /> Dollar increase / ( decrease ) in request : S 25 , 000 <br /> Percent increase /( decrease ) in request * * : # DIV /0 ! <br /> ; Unduplicated Number of Children to be served Individually : 228 <br /> Unduplicated Number of Adults to be served Individually : 40 <br /> Undu licated Number to be served via Group settings : - <br /> Total Program Cost per Client : 189 . 47 <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) . n ; ,% ± 0 � <br /> John H . Dean <br /> Ir <br /> Name of President/Chair of the Board / Sig ure ) <br /> Angelia Perry <br /> Name of Executive Director/CPO ` . Signature <br /> SUMMARY ONLY COMPLETE EXHIBIT a t 7AJ <br /> PROPOSAL ON FILE AT NMI= " <br /> HUMAN SERVICES OFFICE <br />