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Anacnmenr A <br />Proposer Application <br />Agency Legal Name Orange County Conservation Corps <br />Agency DBA (if applicable) <br />Program Name <br />Agency Address 1853 N. Raymond Ave. Anaheim, Ca. 92801 <br />Contact Person Max Carter Title Chief Executive Officer <br />Telephone # 714.956.6222 FAX # 714.956.1944 E-Mail mcarter0hirevouth.org <br />Federal I.D. Number 33-0563781 <br />Agency Status <br />Public Non-Profit Corporation Private Non-Profit x Other <br />Private for Profit Government Years in Operation <br />Primary Funding Sources <br />Funding Source Dept. of <br />Conservation Contracts Charter <br />School OCNEG Proposition <br />' 84 - CCC <br />Amount 2,144,434 500,000 200,000 400,000 400,000 <br />Hours of Operation and Days <br />Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday <br />Hours 7:00-5:00 7:00-5:00 7:00-5:00 7:00-5:00 8:00-12:00 None None <br />My organization will offer the following WIA elements for youth: <br />Tutoring, study skills, training, and instruction, leading to completion of secondary school, <br />including dropout prevention strategies X <br />Alternative secondary school services, as appropriate X <br />Summer employment opportunities that are directly linked to academic and occupational <br />learning X <br />Paid and unpaid work experience, including internships and job shadowing X <br />Occupational skill training, as appropriate, or paid OJT X <br />Leadership development opportunities, which may include community service and peer centered <br />activities encouraging responsibilities and other positive social behaviors during non-school hours X <br />Supportive Services <br />Adult Mentoring for the period of participation and a subsequent period, not less than 12 months I <br />Follow-up services for minimum of 12 months after the completion of participation <br /> <br />Comprehensive guidance and counseling, may include drug/alcohol abuse counseling x <br />Older Youth x Younger Youth x Out-of-School x In-School <br /> <br />Number of youth to be served 2011/2012 <br />Total WIA Funds Requested $ 218-,1'67 ?IAi tW <br />In compliance with the RFP noted above, and subject to the conditions thereof, the undersigned offers <br />to furnish the services stipulated and certifies he has read, understands, and agrees to all terms, <br />conditions, and requIements of this RFP and is authorized to contract on behalf of the agency named <br />above. <br />Signature: ?IAj Title: ?? Date: S'Lr