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The Center for Emotional and Behavioral Health @IRMH- Camp Manatee Therapeutic Summer Camp — IRC- CSAC <br /> PROGRAM COVER PAGE <br /> Organization Name : The Center for Emotional and Behavioral Health @IRMH <br /> Director: Mariamma Pyngolil , RN E-mail : mariamma.Pyngolil (a irmh. org <br /> Address : 1190 37' Street Telephone: 772-563 -4666 ext 1838 <br /> Vero Beach FL 32960 Fax : 772-770-2025 <br /> Program Director: Michelle Bollinger, CTRA E-mail : michelle.bollinger(a irmh. org <br /> Address : 1190 37`h Street Telephone: 772- 563 -4666 ext 1880 <br /> Vero Beach FL 32960 Fax : 772-770-2025 <br /> Program Title : Camp Manatee Therapeutic Summer Camp ` - -1 P 1jl <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: PL-640 . 150-85 Therapeutic Camps-Day camp facility that is <br /> appropriately staffed and equipped to provide an opportunity for children who have developmental <br /> disabilities emotional disturbances, and/or health impairments, who have other limitations or <br /> problems which require special facilities or programming to enjoy a cooperative living experience in <br /> the out of doors . <br /> SUMMARY REPORT — (Enter Information In The Black Cells Only) <br /> Amount Requested from Funder for 2005 / 06 : $ a 0 , <br /> Total Proposed Program Budget for 2005 / 06 : $ 53 , 090 . 21 <br /> Percent of Total Program Budget : 37 . 7 % <br /> Current Program Funding ( 2004 / 05 ) : $ 20 , 000 <br /> Dollar increase / ( decrease ) in request : $ - <br /> Percent increase / ( decrease ) in request * * : 0 . 0 % <br /> Unduplicated Number of Children to be served Individually : 35 <br /> Unduplicated Number of Adults to be served Individually : - <br /> Unduplicated Number to be served via Group settings : 4 <br /> Total Program Cost per Client : 1361 . 29 <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 /> kill <br /> The Organization 's Board ofDirectors *ag approve this applicatio n e <br /> T S kep hc, a <br /> Name of President/Chair of the Board Signa e <br /> Name of Executi e Director/CEO <br /> 3 <br />