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C. Grant requested for next program year: $ 52,'-)00_ 00 <br />D. List all other anticipated sources of funding which will support the <br />Runaway Youth component during the next program year and the amount <br />to be provided by each source. <br />o Per Diems $_ 7,0 <br />o Title XX $ 17488.00 <br />o L.E.A.A. $_11-4t, 00 <br />o In -Kind Contributions $ 13.020.00 <br />o $ <br />TOTAL PROGRAM $102,076.00 <br />II. INSTITUTIONAL AUDIT <br />A. Has your agency submitted a copy of an Institutional Audit Report to <br />the Regional'Grants Management Budget Office? <br />Yes X No <br />B. If yes, date report was submitted. _October, 1979 <br />C. If no, when does your agency plan to submit an audit report? <br />III. STATISTICAL REPORTING AND PROGRAM ADMINISTRATION <br />A. Services Provided Previous Current Future <br />Program Year. Program Year Program Year <br />(Actual) (Estimate) (Estimate) <br />• number of runaway, <br />homeless, and other <br />youth served; 193 215 220 <br />• of those served, the <br />number sheltered; 193 215 220 <br />o of those served, the <br />number positively <br />placed; and 133 168 <br />175 <br />• number of youth non - <br />sheltered but pro- <br />vided other services* 1,600 1,600.00 1,600 <br />* Provided services by the other Youth Service Bureau corrponents. <br />• number of youth pro- <br />vided services on a <br />one time (by phone <br />or drop -in) basis 122 1 -74 200 <br />-2- <br />