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Homelessness and Affordable Housing <br />Funds 2017 Request for Proposals <br />Application Form <br />"Fields outlined in red are <br />required" <br />PROJECT INFORMATION <br />Project Title: Senior Support and Advocacy Program (SSAP) <br />Project Site Name(s): HopeSource <br />Project Site Address(s): 700 East Mountain View Avenue, Suite 501, Ellensburg, WA 98926 <br />Which fund source is this proposal for? (select one, see Section 1 of the RFP for details) <br />Affordable Housing Funds <br />X Homeless and Housing Assistance Funds <br />Total Project Costs (including other funding and resources): $137,057.02 plus 3% annually <br />Total Amount Requested (from Kittitas County Homeless Housing and Assistance or <br />Affordable Housing funds): $128,555.05 plus 3% annually <br />Time Frame for Utilization of Requested Funds: Permanent with review every 5 years <br />City, Town or Unincorporated Area to be served: Kittitas County <br />PLICANT INFORMATION <br />Name of Applicant Organization: HopeSource <br />Mailing Address: 700 East Mountain View Avenue, Suite 501 <br />City, State, Zip: Ellensburg, Washington 98926 <br />Phone: 509-925-1448 <br />Fax: 509-925-1204 <br />Email Address: skgrindle@hopesourcQ.us <br />1 <br />