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<br />, <br /> <br />" <br /> <br />\-. <br />r Novcmb~r]999 <br /> <br />Region V Children's Services Coordinating Committee <br />Grant Application Cover Sheet <br /> <br />Cover Sheet: <br /> <br />Applicant: <br /> <br />The Parenting Resources r:enter <br /> <br />Contact Person: <br /> <br />Kris Bjelde <br /> <br />Address: <br /> <br />1010 2nd Avenue South, PO Box 2806, Fargo. NO 58108-2806 <br /> <br />(I'/cine iIK/III/': cumpletl' physinll adtlrtH 1/1111 PO Boxl <br /> <br />Telephone: <br /> <br />Application Type: Not For Profit ~ Governmental G:J Private D <br />Entity <br />Fiscal Agent (Ifdlllcrem lh~n applicant): Cass Ccunty Federal IO #45-600-2205 <br />(Lega' 1'1IIiry - agency uf orgalli"utiolllocated ill Nort" Dakow respolIsiblefor grant Jllnds Ilnd recortlkeeping 0/ all expenrfitllf($ dluf incomel <br /> <br />241-5700 <br /> <br />FAX: <br /> <br />241-5935 <br /> <br />Fiscal Agent Address: <br />(CiJlIlplele Physic/II Addren) <br /> <br />211 9th St So, Fargo, ND 58103 <br /> <br />Telephone: 241-5001 <br /> <br />Title of Project: <br /> <br />The Parent Resources Center <br /> <br />]s the Project: <br />Project Duration: <br /> <br />New D <br />Beginning <br /> <br />Existing <br />July 20n2 <br /> <br />w <br /> <br />Expanded 0 <br />Ending June 2003 <br /> <br />(RV CSCCgr{l/lll.'QnlfllCIS IIr~Jor iT o"~-yel" period, starri,,1t 011.. <br />mOnlllll/fa rhe !1WIIt is "lIIlOllIIced being ffceival.) <br />Amount Requested $ 37,390 <br /> <br />Representing 38 % of budget <br /> <br />Collaborative Support Form. <br /> <br />It is required Ihat there will be support/commitment from other agencies/groups. Evidence olt/Iil' <br />support/commitment eilher through collaborative parliciplllion or throllgh fUl/ding needs to he <br />l/ocumelltetl in the attached collaborative support form. The form must have a minimum of two <br />!il/pjWrt agencies/groups. Please include I/(lJlIe!(. addresses, phone /lumhers. am/signatures. The <br />applicant agency .\'/lOlIld 1l0l provide a sigllature of support alld this will not counl IH' one oft"e two <br />minimum required. <br />AI'PLlc..\TIO:'iS SHOULD IlE~~~SIXi22 TYPEWRITTF:N PAGES.I:\CLI}D'-~G BUDGET <br />~'.-\RR.\TI\'L [JUT EXCLlIDI:\G BUDGET REPOI{Tl\G FORMS AND I.!!I COI.LBOR.\TIVE.!::QE.H OF' <br />SI,'I'I'OIH OR COM:\IITME:'-iT. Please return the original plus seven (7) conics of the :lpplicatinn. <br />011(~' /1nl! projecl/iJrogmm per applicatio/l. Thank you for taking the;: time;: to submit an application. <br /> <br />..-,-- <br />( <br /> <br /> <br />, <br />, <br />.i <br /> <br />.~..- <br /> <br />'-1',1;,;,- '~ <br />Dat~ <br />./-/~ -c' L <br /> <br />/ Date <br />'1-12- o.z- <br />Date <br /> <br />3 <br />