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<br /> . MINNESOTA <br /> BOARD OF GOVERNMENT <br /> INNOVATION AND COOPERATION <br /> . PRE-APPLICATION <br /> COYER PAGE <br /> 1. Applicant Name(s) List all proposed applicants. <br /> -Northwest Youth & Family Services <br /> -Cities of: Shoreview, Roseville, Little Canada, Falcon Heights, Lauderdale, <br /> Arden Hills, North Oaks <br /> 2. Contact P,erson This'person should be able to respond to questions regarding the pre-application. <br /> Name: Kav Andrpw~ Address: ~Jt-?~.~ Highway 8, Hal. , <br /> Title: Executive Director , New Brighton, MIl 55112 <br /> , <br /> Agency: Northwest Youth & Family Servires <br /> Tclephone Number. (612) 636-5448 FaxNumbcr: (612) 636-1584 <br /> 3. Grant Program IdentifY the grant cdtegory for which you are submitting this proposal. <br /> 0 Service Budget Management Model grant ($50,000 maximum) <br /> . <br /> , , Cooperation Planning grant ($50,000 maximum) <br /> Ki Service Sharing grant ($100,000 maximum) <br /> 4. Estimated Costs <br /> Total estimated cost of the proposal $ 100.000 <br /> Estimated grant request $ 100,000 <br /> This pre-application is submitted to the Board of Government Innovation and Cooperation pursuant to <br /> M.S. 465.798, 465.799, or 465.801. To the best of my knowledge, the information contained in this <br /> proposal is accurate and complete. <br /> .. ;::J' <br /> .~ '--~""--' y Andrews~ Executive Director 08/23/94 <br /> (Signz.ture) (1i~< ) (0)1<) <br /> (The cover page must be signed by the senior elected ,?r administrative official of one applicant agency.) <br /> , <br /> . (SEE OTHER SIDE) <br /> ------- -------- <br />