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Attachment A (Cover Page) <br />PROPOSER APPLICATION <br />Agency Legal Name <br />Orange County Conservation Corps <br />Agency DBA <br />Charter School <br />Program Name <br />x <br />Agency Address <br />1853 N. Raymond Ave, Anaheim, CA 92801 <br />Contact Person & Title <br />Katharyn Bandoni, Chief Executive Officer <br />Email <br />kbandoni@hireyouth.ore <br />Telephone # <br />(714) 956 -6222 <br />Fax # <br />(714) 956 -1944 <br />Federal ID Number <br />33- 0563781 <br />AGENCYSTATUS <br />Public Non -Profit <br />I Cal Recycle <br />Co oration <br />Charter School <br />Private Non - Profit <br />x <br />Years in O eration? <br />12,144,434 <br />Private for Profit <br />200,000 <br />Government <br />1480,000 <br />Other <br />1 8:00 -12:00 <br />PRIMARY FUNDING SOURCES <br />Funding Source <br />I Cal Recycle <br />I Contracts <br />Charter School <br />OCNEG <br />Proposition 84 - CCC <br />Amount <br />12,144,434 <br />1500,000 <br />200,000 <br />400,000 <br />1480,000 <br />HOURS OF OPERATION AND DAYS <br />Days <br />Monday <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />Sunday <br />Hours <br />7:00 -5:00 <br />7:00 -5:00 <br />7:00 -5:00 <br />7:00 -5:00 <br />1 8:00 -12:00 <br />None <br />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, including dropout <br />prevention strategies <br />X <br />Alternative secondary school services, as appropriate <br />X <br />Summer employment opportunities that are directly linked to academic and occupational learning <br />X <br />Paid and unpaid work experience, including internships and job shadowing <br />X <br />Occupational skill training, as appropriate, or paid OJT <br />X <br />Leadership development opportunities, which may include community service and peer centered activities <br />encouraging responsibilities and other positive social behaviors during non - school hours <br />X <br />Supportive Services <br />X <br />Adult Mentoring for the period of participation and a subsequent period, not less than 12 months <br />X <br />Follow -up services for minimum of 12 months after the completion of participation <br />X <br />Comprehensive guidance and counseling, may include drug /alcohol abuse counseling <br />X <br />TARGET POPULATION <br />Older Youth X Younger Youth I X I Out -of- School X In- School x <br /># of Youth to be Served in 2012/2013 125 1 Total WIA Funds Requested 1 $250,000 <br />In compliance with the RFP noted above, and subject to the conditions thereof, the undersigned offers to furnish <br />the services stipulated and certifies he has read, understands, and agrees to all terms, conditions, and <br />requirements of thi RFP and is authorized to contract on behalf of the agency named above. <br />Signature - Title Chief Executive Officer Date <br />