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Standard Face Sheet Page | of | ‘A pplication for Federal ORIGINAL Ed Education Assistance Legal Name. Hesa-triend Program, Inc, Big Brothers Big S._ Adress. 1300 Eluyyood Avenue to wx unr - yey mas, Hreeievs 2. Apples D-U.N-S Naber Note aplean No 4 Applicants LN [161106399 Tile” Mentating Programs 4 Casog offer Domes Asians EEE Aste apc dcogunton any Federal deh? No {eft¥en” cach an exploctin} ‘5. Project Diteetor: Robert F Moss A. Type of Applicant (Pater appropriata loner in she Bex) [I] ‘Addess: 1300 Elwood Avenue A Ste Pubic Calege or Uanerty Bufalo Ny io + 8 boat 1 Noesvoi College or Univeriy + Speral Dincic 1. Non-Profit Organon Sac ARCers 1D ladin Tribe 1. Private, ProfieMakig Organon ‘Teh #: (716) 8784937 Fae: (716) 878-3070 teal K Other (Speci: Independent Schoo Distt E-Mail Addess: baf@buffuet.nct See 9, TypeefSuimision TE Ae any research active involving human sabes planar ‘tay tne daring he popned poet pol! Noam 13) 12s, Areal de reiomch cvs popored signed tbe Non-Construston cenpt ton te mpi em ‘Yes (Provide Pxeaption(s)): 10.15 upplicaion subject to review by Executive Order 12372 process? No Crovide Assnranoe¥, if avaiable} [No ~ Progra hus not ben selected by State fr eview. 15. Deserprve Tle of Applicant's Frojee: Big Brothers Big Sisters of Frie County ~ Site-tased [Sart Dare: Ena Date: Mentoring Program, REC eee 15. To thebestof my knowiedge and belie, ll data i this peapplication! So perenne a ae » srt Shs Cancer ee acne oe “Tpetten tantra Rene tore 4 Lecat ».Tite Excoutve Director ©. Oe “ STAR (716) g7RAGGT Fant (716) 878-3070 Program Income fromm AE Mat Addess: baf@buthaetnct aTOTAL 6. Signatue of Authorised Repeeseattive REV. 1289) . Mints ann IDD AvemdhIn-OM@ARNANIOAS DA TOMAnA ED 524 - Standard * U.S. DEPARTMENT OF EDUCATION BUDGET INFORMATION NON-CONSTRUCTION PROGRAMS ‘Name of Insttution/Organization: Be-a-Friend Program, Inc, Big B Budget Categories 1, Personnel 2. Fringe Benefits 3. Travel 4. Equipment |. Supplies }6. Contractual 17. Construction 8. Other 12, Total Direct Costs ines 1-8) 10. Indirect Costs 11, Training Stipends 12. Total Costs (ines 9-11) ED Form No. 524 Project Year 1 @) i$ 131500 Is 23013 i$ 16400 s 9 ls 16500 1s t5000 s ° is 20488 1s 222901 is 0 s 0 fs 222901 U.S. DEPARTMENT OF EDUCATION FUNDS, Project Year 4 | Project Year Project Year 2 | Project Year 3 ) 95550 1672 20370 0 9425 15000 22 178178 0 0 178178 OMB Control Number: 1890-0004 Expiration Date: 02/28/2003, Page 1 of 2 Applicants requesting funding for only one year should complete tho column under “Project Year 1." Applicants eequesting funding] for multi-year prants should conupicte all applicable coluros. Please read all instructions before completing foc, SECTION A = BUDGET SUMMARY nae © 100328 12857 14774 0 9871 15000 0 21768 174298 o 0 174298 @ eoeccecoe © eoccocose dnd nana AnmfiiandinemeleakS0A Views acnDR A wardNat1 R4ROAOTROR Entld Total (®) 327378 52291 51544 0 35796 45000 0 63368 915377 ° ° 575377 WRON0A ED 524 - Standard Page 2 of 2 spl . U.S. DEPARTMENT OF EDUCATION OMB Contol Number: 1890. BUDGET INFORMATION NON-CONSTRUCTION PROGRAMS Expiration Date; 02/28/2003 Applicants requesting funding for only one year should complet ‘Name of Insttutiow Organization: the coluran under "Project Year 1." Applicants requesting funding, Be-a-Friend Program, Inc, Big B.. for multi-year grants should compiete all applicable columns. Please read all instructions hefure completing, form. SECTION B - RUDGET SUMMARY 5 NON-FEDERAL FUNDS Budge campos’ f°? 1. Personnel 2. Fringe Benefits 5, ‘feavel 4. Equipment 5. Supplies 6. Contractual 7. Construction 8. Other 9. Total Direct. Costs dines 1-8) 10. Indirect Costs 11, Training Stipends 12, Total Costs (fines 9-11) Ihttn-/loerante ed onvle-Annlviewfarme/earS?4 View asn?PR AwardNo=(H R4RO401RO&Entld 7/8/7004