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Attachment A (Cover Page) <br />PROPOSER APPLICATION <br />Agency Legal Name <br />Taller San Jose r` <br />Agency DBA <br />James Irvine <br />Program Name <br />Workforce Training for At -Risk Youth <br />Agency Address <br />801 North Broadway .,'�tA\y -t F\U �_ <br />Contact Person & Title <br />Shawna Smith <br />Email <br />ssmithOtallersaniose.ore <br />Telephone # <br />714- 543 -5105, x109 <br />Fax # <br />714 - 543 -5032 <br />Federal ID Number <br />59- 3816355 <br />AGENCYSTATUS <br />Public Non - Profit <br />Cedar <br />Corpor ation <br />James Irvine <br />Private Non - Profit <br />x <br />Years in O eration? 1771 <br />Foundation <br />Private for Profit <br />Foundation <br />Govermnent <br />8:30 — 5:00 <br />Other <br />8:30 — <br />5:00 <br />PRIMARY FUNDING SOURCES <br />Funding Source <br />Cedar <br />Sisters of St. <br />James Irvine <br />California <br />REDF <br />Saturday <br />Foundation <br />Joseph <br />Foundation <br />Wellness <br />8:30 — 5:00 <br />8:30 — 5:00 <br />8:30 — <br />5:00 <br />Adult Mentoring for the period of participation and a subsequent period, not less than 12 months <br />x <br />Foundation <br />x <br />Amount <br />1 $225,000 <br />$282,936 <br />$125,000 <br />$165,000 <br />$250,000 <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 />8:30 — 5:00 <br />8:30 — <br />5:00 <br />8:30 — 5:00 <br />8:30 — 5:00 <br />8:30 — <br />5:00 <br />Adult Mentoring for the period of participation and a subsequent period, not less than 12 months <br />x <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 />Alternative secondary school services, as appropriate <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 Out -of- School x In- School <br /># of Youth to be Served in 2012/2013 120 1 Total WIA Funds Requested 1 $126,795 <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 this RFP and is authorized to contract on behalf of the agency named above. <br />Signature Title <br />s <br />r <br />Exhibit A <br />7 -;'0-1 -Date !f <br />r <br />