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Account Name Past Actual 3 <br />$ <br />Projected <br />$ 0.00 <br />I n-Kind Contributions (except volunteerism) <br />Application Certification <br />The applicant here certifies and affirms: 1. That it does not now nor will it during the performance of any contract arising <br />from this application, unlawfully discriminate against any employee, applicant for employment, client, customer, or other <br />person who might benefit from said conlract, by reason of age, race, color, ethnicity, sex, religion, military status, serual <br />orientation, creed, place of birth, or disability; 2.Thal it will abide by all relevant local, state and federal laurs and <br />regulations and; 3. That it has read the information contained in the lnstructions on pages I and2 and understands and <br />will comply with all provisions thereof. <br />Certified by: <br />tu(i*lffit <br />Past Actual 2 <br />$ o.oo <br />Past Actual 1 <br />$ 0.00 <br />Name* <br />Applicant's Title* <br />Leslie Thurston <br />Account Name <br />Contributions of Volunteer Time <br />Past Actual 3 <br />$ o.oo <br />Past Actual 2 <br />$ 0.00 <br />Past Actual 1 <br />$ 0.00 <br />Projected <br />$ 0.00 <br />Number of Hours <br />Revenue Totals <br />Expense Totals <br />Profit & Loss <br />Expenses <br />Past Actual 3 Past Actual 2 Past Actual 1 <br />Calculated Value of $ 0.00 <br />Projected Volunteer <br />Time <br />Past Actual 3 <br />$ 25000.00 <br />Past Actual 2 <br />$ 25000.00 <br />Past Actual 1 <br />$ 26500.00 <br />Projected <br />$ 15000.00 <br />Account Name <br />Marekting & Promo <br />Past Actual 3 <br />$ 5s000.00 <br />Past Actual 2 <br />$ 65000.00 <br />Past Actual '1 <br />$ 94000.00 <br />Past Actual 'l <br />$ 94000.00 <br />Projected <br />$ 150000.00 <br />Past Actual 3 <br />$ 55000.00 <br />Past Actual 2 <br />$ 65000.00 <br />Projected <br />$ 150000.00 <br />Projected <br />0 <br />Past Actual 3 <br />$ -30000.00 <br />Past Actual 2 <br />$ -40000.00 <br />Past Actual 1 <br />$ -67500.00 <br />Projected <br />$ -135000.00 <br />Executive Director