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<br /> . MINNESOTA <br /> BOARD OF GOVERNMENT <br /> INNOVATION AND COOPERATION <br /> . PRE-APPLICATION <br /> COVER 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 /> , , <br /> Arden Hills, North Oaks ' <br /> 2. Contact Person Thisperson should be able to respond to questions regarding the pre-application. <br /> Name: Kay Andrews Address: !lJL?~_d Highway 8, 1110l . <br /> Title: Executive Director New Brighton, MN 55112 <br /> Agency: Northwest Youth & Family Servi?eS . <br /> Telephone Number: (612) 636-5448 Fax Number: (612) 636-1584 <br /> 3. Grant Program IdentiJY the grant cdtegory for which you are submitting this proposal. <br /> . 0 Service Budget Management Model grant ($50,000 maximmn) <br /> ;-; Cooperation Planning grant ($50,000 maximmn) <br /> KX Service Sharing grant ($100,000 maximmn) <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, or465.801. To the best of my knowledge, the information contained in this <br /> . .droposal is accurate and complete. <br /> . -,~ ~y Andrews, Executive Director 08/23/94 <br /> (Sig.n:t1utl:) (Title) (Dale) <br /> (The cover page must be signed by the senior elected or administrative official of one applicant agency.) <br /> '< <br /> . (SEE OTHER SIDE) <br />