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r ' Homelessness and Affordable Housing Funds <br />2017 Request for Proposals Application Form <br />Iaifill••irii ^I1 <br />"Fields outlined in red are required" <br />PROJECT INFORMATION <br />Project Title: Women's Sober House <br />Project Site Name(s): <br />Project Site Address(s): TBD <br />Which fund source is this proposal for? (select one, see Section 1 of the RFP for details) <br />® Affordable Housing Funds <br />4 Homeless and Housing Assistance Funds <br />Total Project Costs (including other funding and resources): $67,431.00 <br />Total Amount Requested (from Kittitas County Homeless Housing and Assistance or Affordable <br />Housing funds): $552,212.00 <br />Time Frame for Utilization of Requested Funds: January 1 st 2018 to December 31 st 2019 <br />City, Town or Unincorporated Area to be served: Ellensburg, WA <br />APPLICANT INFORMATION <br />Name of Applicant Organization: HopeSource <br />Mailing Address: 700 E Mountain View Ave #501 <br />City, State, zip: Ellensburg, WA 98926 <br />Phone: (509) 925-1448 <br />Fax: (509) 925-1204 <br />Email Address: <br />