HONEST ‘Table of Contents Lesson One ~ Sex, Emotions and Self-Respect. “Males Vs. Females” Video Segment One... Guys and Girls Are Different. Six Emotional Effects of Premarital Sex. Character Application: Sex and Self-Respect. Lesson Two ~ Sex, Alcohol and Respect. “Sex and Alcohol Don’t Mix” Video Segment Two. What Do You Know About Alcohol ? «.......+++++ ‘The Danger of Binge Drinking...............-++-+-+ The Physical Effects of Alcohol Abuse. Character Application: Sex and Respect... Lesson Three ~ Sex, STDs and Honesty... “A Visit to a Microbiology Lab” Video Segment Three. The Most Common Sexually Transmitted Diseases How STDs are Spread... What about “Safe Sex"? Character Application: Sex and Honesty Lesson Four ~ Sex, Teen Pregnancy and Responsibility. “Nicole and Raoul” Video Segment Fou Who Suffers the Consequences?... Reducing the Risk of Teen Pregnancy. Consequences of Choices. 7 Character Application: Sex and Responsibility. Lesson Five — Sex, HIV/AIDS and Compassion. “A Life-Changing Visit to an AIDS Clinic” Video Segment Five. What Happens if You Contract HIV. ae Ten Common Myths About HIV/AIDS... Character Application: Compassion.. Lesson Six ~ Sex, Love and Choices. “Choosing Abstinence” Video Segment Six Decisions About Sex.... . . Choosing The Best Relationship... Infatuation or Love?. Character Application: Sex and Choices.Lesson Seven — Sex, Limits and Self-Discipline ......... “Dealing with Pressure” Video Segment Seven ‘The Five Sources of Pressure Becoming Pressure-Proof.. Character Application: Sex and Self-Dis Lesson Eight — Sex, Saying “NO” and Courage. “Taking a Stand” Video Segment Eight... Developing Assertiveness Skills. Saying “NO” with Positive Results. Role-Plays.... : . Character Application: Sex and Courage Endnotes.APPENDIX D BIOGRAPHICAL SKETCH (ATTACHMENT G)ATTACHMENT G Biographical Sketch (Note: This form is pending OMB approval) ‘Name (Last, First, Middle Initialy Singer, Barbara A Title: Executive Director, CareNet Pregnancy Services of DuPage Education: Institution and Location Degree Year Completed _ Northern Illinois University, Dekalb, IL, B.A 1986 Professional Experience & Research: List in reverse chronological order (ie. most current first) previous employment and experience. Then list most representative publications using same chronology 1.1998 — Present: Executive Director CareNet Pregnancy Services of DuPage, Westmont, IL 2, 1995 - 1997: Program Director Forest Hospital, Des Plains, IL 1995-1998: Minrith Meier Richardson, Texas : Senior Management Team (1993 — 1995) Regional Director (1991 — 1993) Program Administrator (1988 — 1991) 3. Jan 1999 — Oct 1999: Computer Instructor & Reading Assistant School District #45, Villa Park/Lombard, IL 4, August 1998 - Dec 1998: Student Teacher School District #45, Villa Park/Lombard, IL.ATTACHMENT G Biographical Sketch (Note: This form is pending OMB approval) Name (Last, First, Middle Initial) Meinesnoy Elen Title: Director, Abstinence Education Program Education: Institution and Location Degree ‘Year Completed B.A in Psychology & Elementary Elmhurst College, Elmhurst, IL. Education 1998 Professional Experience & Research: List in reverse chronological order (i.e. most current first) previous employment and experience, Then list most representative publications using same chronology. 1. Jan 2000 ~Present: Director of Abstinence Education Program CareNet Pregnancy Services of DuPage, Westmont, IL. 2. Oct 1999 — Jan 2000: Technology Assistant Hinsdale Middle School, Hinsdale, IL 3. Jan 1999 — Oct 1999: Computer Instructor & Reading Assistant School District #45, Villa Park/Lombard, IL 4, August 1998 — Dec 1998: Student Teacher School District #45, Villa Park/Lombard, ILAPPENDIX E STATUS REPORT/IMPLEMENTATION (ATTACHMENT H)Project Title: Applicant Agency, State: CareNet Pregnancy Services of DuPage, Illinois Budget Perio ATTACHMENT H STATUS REPORTAIMPLEMENTATION PLAN (Note: This form is pending OMB approval) ‘Wait for Your Mate Abstinence Education Program (03 - 06/30/06 Objective Activity Progress! Objective A School | Present curricula to 5 or more school boards « Boards | month, Market Program fo | more schools, | churches and | after-school programs in DuPage County Media | Advertise abstinence program in yellow pages and local newspapers ObjectiveB | Present curricula to parents whose children will | patticipate in our abstinence education program, Parental | Involvement | | | Recruit parents to go through parent-training | | session on how to communicate with your children about sex, "isc provides forges tobe eon. Aso pj ak pce cng saunaATTACHMENT H STATUS REPORT/IMPLEMENTATION PLAN (Note: Ths form is pending OMB approval) Project Title: Wait for Your Mate Abstinence Education Program Applicant Agency, State: CareNet Premnancy Servies of DuPage Ilinois Budget Period: 710103 - 06/3006 Objective | Strategy | Activity Progress! Objective C Train Staff | Hire and recruit competent staff and instructors. [28 Steff Development Meet with staff and instructors to discuss job assignments Establish dates for training ‘Train staff and instructors who will do the | presentations in schools, churches and after- school programs. | scx proves frpogtsstobe repel Aigo, pjesma epee cone is clumeATTACHMENT Ht STATUS REPORT/IMPLEMENTATION PLAN (Note: Tis forms pending OMB approval Project Title: Wait for Your Mate Abstinence Education Program Applicant Agency, State: CareNet Pregnancy Services of DuPave, Illinois Budget Period: 7/01/03 ~-06/30/06 NY Objective | Strategy Activity Progress! Objective D Schedule classes in schools, churches and after- " school programs Schedule Sessions Ensure instructors are aware ofthe schedule and get their commitment in writing, Objective E Peer support. | Establish goals and objectives ofthe support Recruit students | group group with the support group coordinator. for peer support Assign responsibilities. group Aotvely market and advertise support group in| all sessions. Design and start a support group website, ee website | ascolin viesoploges ered, As poi prj tempera eagle herAPPENDIX F STATUS PROJECT TIME ALLOCATION CHART (ATTACHMENT I)ATTACHMENT I PROJECT ACTIVITIES TIME ALLOCATION TABLE (Note: This form is pending OMB approval) Project Title: — Wait for Your Mate Abstinence Education Program Applicant Agency, State: CareNet Pregnancy Services of DuPage, Illinois Budget Period: 7/01/04 - 07/30/07 fine 50 Completion Otjectives and Activites Start : : ‘ . | Date Trckng/Evalution Methods (Same as Attachment H: Implementation Plan Date | CEsinate) | Objective A 7/04 | ongoing | Total Number of schools we present ‘Market Program to more schools | | coricula in e month, OnjectiveB 71/04 | ongoing alanis involved, Parental Involvement ‘oii 715/04 | ongoing Liviu ff eration ever si | Staff Development months, | Qi D ISA ongoing | Sunter cso ately Liase with schools, churches and after-school programs to | schedule classes | Objective E 8/15/04 | ongoing | Attendance records, Recruit students for peer support groupAPPENDIX G PERSONNEL ALLOCATION CHART (ATTACHMENT J)ATTACHMENT J PERSONNEL ACTIVITIES ALLOCATION CHART (Not Ths frm pending OMB approval) Project Title: Wait for Your Mate Abstinence Education Program Applicant Ageney, State: CareNet Pregnancy Services of DuPage, Illinois Budget Period: 7/01/04 - 07/30/07 Objective (and Activites) Staffand Consultants by Abbreviated Position ite in Persons Days PD | PC | AA| I | SGC} A A- Advertise Program to more schools, 100% | 20% | 40% churches and after-school programs | B - Parental Involvement 100% 10% C-Staff Development 100% | 80% D~Schedule classes and present curricula 100% | 10% | 50% | 100% 100% 100% E-Recrut students for peer support group 100% | 10% F-Organize, advertise and hold youth rally | 100% | 50% | 20% |20% 30% | 30% Viel Cd Hea Baas PD~Program Director PC - Program Traine/Coordinator AA~ Administrative Assistant T-Instructors ‘SGC - Support Group Coordinator A~ Assistants to instructorsAPPENDIX H JOB DESCRIPTIONS AND RESUMESPOSITION DESCRIPTIONS 1. Title position: Abstinence Education Program Director 2. Description of duties and responsibilities + Oversee operations of the entire Abstinence Education Program * Speaker for at least one of the days of the program ‘© Oversee Program Assistant, Recruiter, Speakers and Assistants Direct the implementation of the Choosing the Best Program + Recruit speakers and assistants for the program * Design material for promotion of the program + Develop relationships with teachers and facilitators of the schools we present in and maintain these relationships * Coordinate all events and speaking engagements that take place within the program Coordinate all speakers and assistants schedules and when they will be presenting/assisting ‘© Organize and implement yearly youth rally + Oversee training of potential speakers and assistants + Interview potential employees: program assistant, program trainer, speakers and assistants + Work closely with other programs to coordinate activities and assure compliance with program reporting and evaluation requirements. 3. Qualifications for position * College Degree in Education preferred «Experience in public speaking and/or teaching + Ability to relate to a cross-section of people on a professional basis. ‘Willingness to work flexible schedule when necessary. + Effective organizational and writing skills. + Must provide own transportation and a valid drivers license + Has met the requirements of a criminal record check as specified by Illinois State Law. > Supervisory relationships Abstinence Education Program Assistant Abstinence Education Program Trainer Abstinence Education Speakers and Assistants 5. Skills and Knowledge required + Public Speaking/Training © Oral and written communication skills © Computer skills = Organizational skills © The uses of office technology like telephone, fax machine, photocopying machine etc.~ . Prior experience required. Public Speaking or Teaching Experience Managerial Experience preferred Personal qualities Ability to make decisions independently Knowledge of the community and its resources Ability to work and relate well with teensJob Description Abstinence Education Program Program Trainer/Coordinator Duties and Responsibilities + Recruit potential program speakers and assistants ¢ Interview potential speakers and assistants along with the Director of Abstinence Education Train speakers to present the abstinence program Train assistants for their duties in the classroom Report to the Director of Abstinence Education any problems, situations, issues, etc Observe speakers and assistants in the classroom environment and give constructive criticismv/feedback of presentation oes Qualification for Position High School diploma or GED certificate; some college preferred Experience in training others, public speaking or teaching preferred Willingness to work flexible schedule Ability to relate to a cross-section of people on a professional basis, Effective organizational and writing skills ‘Must provide own transportation and a valid drivers license Has met the requirements of a criminal record check as specified by Illinois State Law eoeeeee ‘Supervisory Relationships Speakers and Assistants for program Skills and Knowledge Required % Goals and Objectives of Abstinence-only Education Program Oral and Written Communication Skills © Uses of office technology (computer, telephone, fax machine, copier, etc.) Prior Experience Required ¢ Teaching/training experience preferred Personal Qualities + Ability to instruct others in a constructive way Work independently with little directionPOSITION DESCRIPTIONS 1. Title position: Abstinence Education Program Assistant x . Description of duties and responsibilities * Compiles and completes statistical data on reports and surveys from the schools. * Prepare worksheets, brochures and all needed visual materials to be used in the schools + Maintain records and prepare reports for schools ‘* Assist in the organization of a system for record keeping and maintain records in a manner consistent with confidentiality status. + Assist in designing forms and reports, establish and maintain records and files, develop indexes and other record keeping procedures as needed = Answer telephone calls, e-mail and mail, respond to inquiries from the schools 3. Qualifications for position + High school diploma or G.B.D certificate and some college education preffered + Ability to relate to a cross-section of people on a professional basi «Willingness to work flexible schedule when necessary. + Effective organizational and writing skills, 4, Supervisory relationships None 5. Skills and Knowledge required Record keeping and reporting * Oral and written communication skills © Computer skills = The uses of office technology like telephone, fax machine, photocopying machine etc. 6. Prior experience required. 7. Personal qualities Work independently with little direction Knowledge of the community and its resources Ability to work with teensEllen McInerney rime Dl Email: OBJECTIVE To obtain a full-time managerial position where I can use my college education, knowledge and experience in the areas of youth education and public speaking. QUALIFICATIONS Double major in Elementary Education and Psychology, passionate and experienced in educating teens and single people about the importance of abstinence until marriage, extensive public speaking background, and strong organizational skills. EDUCATION 1996-1998 Elmhurst College, Elmhurst, IL Bachelor of Arts in Psychology and Education, May 1998 Blementary Education Certification type 03, December 1998 1994-1996 College of DuPage, Glen Ellyn, IL WORK HISTORY Director of Abstinence Education, Care Net Pregnancy Services, Wood Dale, IL 8/01-Present Speaker for the ‘How and Why to Wait’ day of the Wait For Your Mate Abstinence Education Program, Responsible for the overall development, implementation and operation of the abstinence education program. These responsibilities include: conducting biannual volunteer training seminars for potential abstinence speakers, recruit, select and interview volunteers for the program, provide extensive individual training sessions for new speakers to develop their skills in abstinence speaking, and schedule and implement all presentation requests and appropriate speakers. Other responsibilities include: facilitate monthly volunteer meetings; create new program material, as well as evaluate, select and maintain educational materials and resources for the program; develop and promote materials for the program; develop and maintain professional relationships with the teachers, youth pastors and leaders who use our program; promote the program to pastors, churches and organizations throughout the community; provide on-going counsel and discipleship for students in the area of abstinence; recruit and establish a prayer chain specifically for the abstinence program; develop and implement an abstinence website for our program. Also, creating an abstinence education video and working with Christian music artists to do so. Office Manager, Care Net Pregnancy Services, Westmont, IL 1/00-7/01 Assisted Executive Director as well as performed multi-faceted tasks for the general managing of the center. Extensive work with the public, volunteers and all staff. Also served as volunteer speaker with the Love with Liberty for Life Abstinence Education program. Extensive computer, Internet and workTechnology Assistant, Hinsdale Middle School, Hinsdale, IL 10/99-1/00 ‘Assisted Media Coordinator in various technological activities: networking iMacs and Internet, writing labs, troubleshooting, computer repair, email accounts, instruction of student classes, installation of software, disk repair and other technical duties. Also served as a substitute teacher when needed. COMPUTER SKILLS + Certification in ClarisWorks, Internet Technologies, Power Point, Classroom Teaching Technologies, and Proprietary Software. Extensive work with Microsoft Office: Word, Excel, Access, as well as a donor software program called ACT! 4.0 and Outlook Express. SPEAKING/ABSTINENCE EXPERIENCE, + Began volunteering for Care Net as an abstinence speaker in December of 2000. ‘¢ Promoted to Director of Abstinence Education for Care Net in July 2001 + To date have personally educated over 3,500 teenagers in public and private schools as well as youth groups, during the school year with the message of abstinence. + Present “How To Teach Your Child Abstinence” seminars to parents of teenagers. To date have presented to an estimated 500 parents ¢ Promote Care Net and Sanctity of Human Life to churches on SOHL Sunday every January. Promote Care Net and the abstinence program as well as education regarding abstinence to churches throughout the year. ‘¢ Presented an abstinence presentation in the Dominican Republic to an estimated 70 teens and adults who were serving on a mission trip. Certified in June 2001 as a W.A.L-T. (Why Am I Tempted) Training Instructor with Choosing the Best abstinence education program. ‘+ Member of the National Abstinence Association and completed requirements with the NAA for National Professional Certification as an Abstinence Educator. MINISTRY SERVICE + Short-term mission trip in July 2002 to Reynosa Mexico with the high school youth group from Elmhurst Christian Reformed Church and Adventures in Missions (AIM) to serve a community with construction, evangelism, Vacation Bible School and church services '¢ Short-term mission trip in July 2001 to the Dominican Republic with the high schoo! youth group from Elmhurst Christian Reformed Church and AIM to serve a community in the Dominican with construction of a church, street evangelism, prayer walks, Vacation Bible School and church fellowship. ¢ For the school year of 2000-2001, co-lead an eighth-grade girls’ Bible study through Elmhurst Christian Reformed Church's youth group. 4 Short-term mission trip in November 1999 to Kostroma, Russia with two organizations: Children's Hope Chest and Buckner International. We visited orphanages daily bringing the love of Christ and the message of His salvation as well as food and clothing to the orphans, © Created and managed a one-year short-term ministry in 1998-1999 for hungry children in public elementary schools to receive breakfast every morning before school.REFERENCES Harma Slinkman Director of Operations, Care Net Pregnancy Services of DuPage, Westmont, IL- Office: (630) 455-0335 Home: (708) 343-1962 John Lynch Student Ministries Director, Elmhurst Christian Reformed Church, Elmhurst, IL Cell: (630) 886-1003 Office: (630) 279-5516 Email: johnslynch@yahoo.com Judi Duffy Director of Client Services, Care Net Services of DuPage, Westmont, IL Office: (630) 455-0335 Home: (630) 322-8931 Scott Pennington ‘Area Representative, Fellowship of Christian Athletes, OH Work: (419) 842-1824 Home: (419) 693-5880 Email: spennington@fca.orgConnie Armerding ve tnaite | be OBJECTIVE ‘A challenging and progressively responsible position in teaching and developing abstinence education, EDUCATION REI Bachelor of Arts — Communications ‘May 2002 ‘Wheaton College, Wheaton, IL Related Coursework: Public Speaking, Interpersonal Communication, Family Communication, Gender Communication, Communication Theory, Group Dynamics, Organizational ‘Communication, Sociology, and Psychology ED EXPERIEN( Young Life Leader at Glenbard West High School (1998-present) © Coordinate weekly club meetings and weekend retreats for high school students = Organize weekly meetings for team of nine college volunteers ‘© Lead weekly small group meetings for high school females WORK EXPERIENCE Prevention Educator July 2002 Care First Prevention Services Chicago, IL Developed Abstinence curriculum used in the city and suburban schools of Chicago Coordinate speaking engagements with a number of school districts ‘Teach numerous classes of high school students on a weekly basis, Educate students on healthy sexual decision making ‘Train student speakers ‘Salesperson Falt 2001 Nordstrom Department Store ‘Oakbrook, fL Utilize competency in interpersonal communication when dealing with clients ‘© Organized merchandise on the sales floor ‘= Provided customers with exceptional customer service Independent Marketing Analyst Fall 2001 Community School of The Arts Wheaton, 1 + Participated in an independent marketing analysis for The Community School of the Arts ‘© Developed a comprehensive survey that assessed 113 organizations’ needs ‘© Presented results in written and oral form to client Summer Intern ‘Summer 2000 Rita B. & Co. (Public Relations Firm) Visalia, CA ‘© Critiqued and proof read office publications and related materials, ‘© Assisted in the layout and design of advertisements ‘© Contacted clients within the community through phone calls and site visitsAPPENDIX I STATEMENTS OF ASSURANCESAppendix H ASSURANCES CareNet Pregnancy Services of DuPage will provide only those activities and projects, which are consistent with abstinence education as defined in Section 510 Tile V of the Social Security Act. CareNet Pregnancy Services of DuPage will abide by the requirements of the SPANS. Community-Based Abstinence Education program to make this program accessible to the general public. CareNet Pregnancy Services of DuPage will not use the federal funds for sectarian instruction, worship, prayer or proselytization. CareNet Pregnancy Services of DuPage agrees not to provide discussion of other forms of sexual conduct. Apliatacrh yas) QL lacdenga) Exefutive Director CareNet Pregnancy Servicks df DuPage January 5, 2004Appendix J Letters of Support2110 rove Hove ones Oye Geers ‘nnn Se teat ‘sah oa Congress of the United States PHouse of Representatives ‘Blashington, BE 20515-1306 January 13, 2004 JUDICIARY HRSA Grants Application Center 901 Russell Avenue Suite 450 Gaithersburg, Maryland 20879 To Whom It May Concern: I would like to offer my enthusiastic support for the federal grant application submitted by CareNet Pregnancy Services of DuPage County. CareNet has applied for a federal grant (CFDA 93.110) to fund its community-based abstinence education program. Therefore, | would appreciate any assistance you could offer this organization Using this grant, CareNet plans to promote abstinence among adolescents, thereby hoping to decrease out-of- wedlock sexual activity among local teens. Tam sure I do not need to tell you about the health risks associated with out-of-wedlock sexual activity and with resulting pregnancies. Like elsewhere, teen births in suburban Chicago have continued to increase over the years, as have cases of sexually transmitted diseases. Therefore, abstinence programs like that of CareNet are desperately needed in DuPage County, which is why I am pleased that the federal government has chosen to provide a competitive grant progrant to encourage the formation of such programs. Lam also pleased that CareNet has pledged to collaborate with other non-profit and faith-based organizations in order to reach as many teenagers as possible, The organization’s goal of reaching 6,000 teens in its first year of operation is commendable. ‘Therefore, I again offer my full support for this program and urge you to give CareNet’s application a fair and thorough review. In addition, [ ask that you keep me informed as to the status of CareNet’s loan application. ‘Thank you in advance for your attention to this matter. Very truly yours, Henry le ‘nas sranonenrenarep onus ane ormcrceoretas @ILLINOIS STATE SENATE PETER J.ROSKAM SENATE REPUBLICAN WHIP STATE SENATOR + 48TH OISTRICT December 22, 2003 Grants Management Officer (MCHB) HRSA Grants Application Center 901 Russell Avenue, Suite 450 Gaithersburg, Maryland 20879 Dear SPRANS Review Committee: This letter is in support of securing a SPRANS Abstinence Education Grant for CareNet Pregnancy Services of DuPage. CareNet Pregnancy Services of DuPage is an established non-profit organization and has supported and encouraged strong healthy families in DuPage County, IL by assisting those experiencing unplanned pregnancies and through their abstinence-only education program since 1981 1am writing in strong support of CareNet Pregnancy Services and particularly their efforts in abstinence-only education. I am pleased that CareNet has taken the initiative on this essential issue and that they are committed to protecting our young people with a solid message of abstinence. The reputation that CareNet enjoys is outstanding and I am honored to be among their supporters. 1 am confident that any grant funds entrusted to CareNet will be well used and yield excellent dividends. I highly recommend CareNet and request that you consider funding them with a SPRANS implementation grant. feter J. Roskam, tate SenatorDISTRICT OFFICE: ILS. WHEATON AVE.. SUITE 101 WHEATON, ILLINOIS 60187 630-221-0040 (630.221.9466 FAX COMMITTEES: + JUDICIARY 1- CIVIL LAW: ‘MINORITY SPOKESPERSON = PUBLIC UTILITIES + FINANCIAL INSTITUTIONS + Lamon + APPROPRIATIONS - PUBLIC SAFETY “SPRINGFIELD OFFICE: DIN STRATTON BLDG. SPRINGFIELD, ILLINOTS 62706 a RANDALL M. HULTGREN STATE REPRESENTATIVE © 95" DISTRICT January 20, 2004 ‘The HRSA Grants Application Center ‘The Legion Group, Inc. Attn: Grant Program Program Announcement No. HRSA — 04-077 CFDA No. 93.110 901 Russell Avenue, Suite 450 Dear SPRANS Review Committee: This letter is in support of securing a SPRANS Abstinence Education Grant for CareNet Pregnancy Services of DuPage. CareNet Pregnancy Services of DuPage is an established non-profit organization and has supported and encouraged strong healthy families in DuPage County, IL by assisting those experiencing unplanned pregnancies since 1981. They provide services that help promote their client’s physical, social and emotional health. In order to protect the adolescence reproductive health, they are reaching youth in schools and churches with the message of abstinence until marriage. Their Abstinence- only Education Program secks to challenge teens to save sexual activity for marriage by educating them of the physical and emotional consequences of pre-marital activity. ‘Awarding a grant to advance CareNet Pregnancy Services of DuPage Abstinence-only Education Program will amount to an investment that will yield incalculable returns here in DuPage County. I highly recommend CareNet and request that you consider funding, them with a SPRANS implementation grant. With We I Randall M. Hultgren State Representative — 95" DistrictELMHURST PUBLIC SCHOOLS 130 West Madison Streat Elmhurst, Mlinois 60126-4838 (630) 834-4590 « Fax (630) 617-2345, SANDBURG MIDDLE SCHOOL Howard E. Holbr 345 E. St. Charles Road Pica oe Elmhurst, 1L 60126 (630)834-4534 Fax(630)617-2380 To whom it may concern: I'm writing to wholeheartedly support the abstinence message of the CareNet Organization which includes the Wait For Your Mate program. We've had the CareNet people in our classrooms for a number of years now. The impact they have on our young people is both profound and long lasting. They deliver the facts and figures, then back it up with a real life example who speaks with our students making powerful points for abstinence. Our students have before them someone who walked on the “wild side,” wanted what the world had to offer, desired the media-massaged ideals, and paid an unforgiving price. Facts and figures, coupled with this most sincere message has quite an affect on our students. The CareNet people have turned “another school subject” into a high-impact abstinence program where life-long decisions are made. Again, | wholeheartedly recommend the CareNet Organization and their abstinence message. Sincerely, Edn ffole__ Edward Poole Middle School Counselor Abstinence Education TeacherBER THE ADMINISTRATIVE OFFICE CASS JR. HIGH SCHOOL CONCORD SCHOOL Mrorbayfont | vesaOdey fend r0 Cm ss Cass School Darien, liinots 60561 Darien, Hlinois 60561 Darien, liinois 60561 i: {630} 985-2000 (630) 985-1900 (690) 968-3026 Sy District 63 Fax: (630) 985-0225 Fax: (620) 985-2881 Faxc (630) 968-0626 Keto. Kah, Siete eee ay skacceape Pea Unra riPs mennight@cased63.07g Harley @cassd63.org January 7, 2004 To Whom It May Concern: Our school is fortunate to have Ellen McInerney and her “Wait for Your Mate” Abstinence Program at our school. Our students have benefited immensely from this program. It is encouraging when students can receive honest and insightful reasons for considering abstinence from sexual behavior until marriage Ifever a program was worthy of financial support “Wait for Your Mate” surely qualifies, Itis a valuable tool that clearly explains the risks of teen sexual behavior and reinforces the positive advantages of “waiting for your mate”. Itis my hope that your organization would consider a much needed grant for the continuation and/or enhancement of this program. Respectfully, Peter J. Scariano Science/Health Teacher Cass Jr. High Darien, IL 60561 www.cassd63.019DRISCOLL CATHOLIC HIGH SCHOOL VALUES EDUCATION LEADERSHIP January 9, 2004 Regarding the Care Net Abstinence Education Program: Being a health teacher by profession, | am very aware of the needs of young people, many whose needs are never met unless organizations like Care Net fill the void. Ihave had Care Net services present their “Abstinence program to my students for four years now. Lam very grateful for the steps they take to helping, young people make wise and better choices through promoting abstinence. ‘Awarding a grant to improve a soid program will amount into an investment inthe country's future. truly believe that young people do not set out to make poor choices. [also belive that they need the help and guidance of the personnel at Care Net services. It is without reservation that I ask you to award a grant to help further the work of Care Net services. The Tove and care the have shown my students in their work has been sustained for many years. Please, help ‘that work to continue. Sincerely, Hay by Phe ‘Amy Jo Rehder Health Teacher, Driscoll Catholic High School 555 N. LOMBARD ADDISON, ILLINOIS 60101-1998 (630) 543-6310 Fax (630) 543-1638 www.driscollcatholic.com A LASALLIAN SCHOOL IN THE CHRISTIAN BROTHERS TRADITIONLisle Senior High Schoo! 1800 Short Street Lisle, Minois 60532 LISLE- COMMUNITY Ron Logeman Principal 630/493-8300 630/971-1234 (Fax) ‘To Whom It May Concern: Thave been a health teacher for fifteen years and through my experiences I have seen the significant importance for young people to gain information, materials, and first-hand knowledge of alternatives to sex. Care-Net has been that bridge for them. I believe in their Abstinence Education Program so much that I have relieved all other related programs for Care-Net’s three day program. I am very satisfied that they are taking steps to continue helping young people make wise and better choices with the help of this program. On behalf of our students, parents, and faculty members at Lisle High School, we strongly support Care-Net and any offerings on behalf of our young students, and quite possibly some guidance on tough choices in there young lives. Health Educator ‘Quality Education for the Youth of LisleFuruees Founven on Fawiuy To Whom It May Concern: St. Francis High School is blessed to have Care Net’s Wait For Your Mate Abstinence Program. This program provides more than just information. They also provide materials, and first-hand knowledge, or testimonials, of the consequences that could occur due to ‘engaging in risky sexual behavior before marriage. As the health teacher at St. Francis High School, I am able to see the effects this program has on our students. They look forward to the speakers’ presentation and more often than not, walk out of class continuing to discuss the material with their peers. This presentation has an impact on the student's lives and the choices they make. The students listen to the testimonials with a sense of wonder and through that are encouraged to consider the consequences that can occur due to making poor decisions. This particular program covers all the areas of concern for making fully informed sexual decisions. By providing Care Net with this grant, their program could be even further developed which would be an investment not only to Care Net Pregnancy Services of DuPage, but also to all the students that benefit from their program. Iti exciting for me to be able to provide the students with the Wait For Your Mate program because of the creative and interesting approaches used to demonstrate that abstinence is the best choice. This program provides students with guidance and assistance they may not receive from any other source. Any assistance granted to their efforts would be a helping hand that will benefit St. Francis as well as all of DuPage County. Their efforts consistently shine through and their dedication is an asset to all of the schools they attend. If we can assist in any way to benefit this program, we would also be assisting our students. I am honored to write this letter and am available for any further assistance Care Net may need. Sincerely, 7130 WEST ROOSEVELT ROAD ~ WHEATON, ILLINOIS 60187-6029 + (630) 668-5800_- FAX: (630) 668-5893 wre ssnet orgBob Close Diana Harris Martin Beime Principal Asst. Principal Asst. Principal 2721 Stonebridge Blvd. * Aurora, llindis, 60504 * 630/375-1010 ‘To Whom It May Concern: Granger Middle School is very fortunate to have Care Net's wait for your mate abstinence education program at our school. Care Net provides our students information, materials, and first-hand knowledge of alternatives to sexual relationships. It is exciting to hear about the creative projects and approaches presented through this program. Abstinence education, through Care Net has made impeccable strides in the lives of our students, They look forward to the speakers' testimonials, are in awe of the story, and are more receptive to believe the consequences of negative choices. On behalf of our students, parents, and faculty members at Granger Middle School, we fully support Care Net and the abstinence education program. We further pledge to be available to assist in any way we can for the benefit of our students. Sincerely, pape Vogel Stow * Jacque Pagels Scott Branson Health Education Health Education Granger Middle School Granger Middle SchoolCHECKLIST Public Burden Colecton of ‘esponse,incusing tho tina for existing data courses, gathering ‘Statement: Public reporting burden of this Information is esimatod to average 450 hous par ‘ovewng ington, sourcing ‘and malralning the data nosded, olecdon et ivormation. At Page 25 (OMB Approval No. 0920-0428 pinion Dat: Apel 30,2000 ton Road, MS 0-24, Atlanta, GA 30333, ‘Oo'not sund tho camplated’ form to is ‘Clearance Oteer, 1600 C AYTIE PRA (0920.0820), ‘ares. tea elt an oven) th, ce (Aj MOTE,.TO APPLICANT: Tie tam, must bo compeod and sgoncy. Ceniict or sponsor, and’a persons not roqured sueraaod ‘xiginal of your application, Be sure to complete errant a cntocson a iia oe a ned ee lus o us farm Ce Be potions and foes Faas Sco Cont ruber. Send comments epating the intamaton foqueniad Ts tam Shed bs aed oe et {hig burden ‘stmato or any’ oer ths colaction ‘ot alte signed orginal ofthe appestion. This page foserved Ilormaton inducing siagoatons loc receanptse utente coe, Reg Megane’ ot Noncompeting Competing ‘Type of Application: New __ [0] Continuation Gontinuation —_[E} Supplemental PART A: The following chackilt is provided to assure that proper slgnelures, arcurances, and coviicaloay evan : Included Applicable 1. Proper Signature and Date for item 18 on SF 424 (FACE PAGE) 2. Proper Signatur and Date on PRIS St6i-t Conmechones Aa 3. Proper Signature and Dato on appropriate “Assurancos’ paper a, ‘SF-4248 (Non-Construction Programs) or SF-424D (Construct Programs) i) 4. tyour organization curred hae on fe wih DHS the folowing assurances, please idontly which have been fied by iciestng the dato of such fing on the ine provided. (Alfour have boon ‘consolidated into a singlo form, HHS Form 690) Givi Rights Assurance (45 CFR 80) ‘Assurance Concerning the Handicapped (45 GER 84)” ‘Assurance Concaming Sex Disermunaion (45 CFR 86) ‘Assurance Cancersing Age Discrimination (45 CFR 90 & 4SCFR 91) Human Subjects Has a Pubic Hoalth System Impact Statement been compoted and dstibuted as raquos? Has the appropiate box bown ch ‘egardingintorgovernmental ro Has the entre proposed project PAGE? ws : ‘equi. : Has the “Bigot niin? pag ‘SFAB4A (Nion Con: Has the 12 month detailed budget been provided? provided? ...... For a Suppiemenial funds requested? srr. For Competing Continuation bboon included? . ification, when applicable (48 CFR 46) for the proposed programiproject wecked for item # 16 on the SF-A24 (FACE PA iow under €.0. 12372 2 (45 CFR Part 100) period been identified in itam # 13 of the FAG Have biographical skeich(es) with jab descipton(e) boon aitachod, when ‘SF 4240 (Consiucion Programs) boon comeeted ana neiea Has the budget forthe entre prepoced projet pred wi slit dal boon apis, hs a dio’ Bada ads iyi ina and Sippel apiaion” Rasa pages aoa tion Programs) or ‘d? PART C: In the spaces provided below, ploase provide the requested Information, ‘snes ctl be noted tan nna be me. tana BARBARA SINGER tan EXECUTIVE DIRECTOR ‘rgeiaton CARENET PREGNANCY SERVICES OF DUE ‘Aadoas 671 N. CASS AVE. WESTMONT, IL 60559-1338, Esra ndaees_ CPSOUPAGE@MEGSINET.COM ‘aephana Humber (630) 455-0335 Fexhmber (630) 789-1919 ‘APPLICANT ORGANZATIONS 12016 OAH EN ea aro ‘Progam OvacorPject OhacedPcpl inet: dented rect ‘be propos pet program tame ELLEN MCINERNEY Ie DIRECTOR, ABSTINENCE EDUCATION PROGRAY remtualon CARENET PREGNANCY SERVICES OF UL ‘Atanas 671 N. CASS AVE., WESTMONT, IL 60559-1336 {Ema Addons CPSOUPAGE@MEGSINET. COM “apron Manbar (630) 455-0335 Faxnumber (630) 789-1913 SOCIAL SECURITY NUMBER ‘WGHEST DEGREE EARNED BA ‘ThePage 26 PART D: A private, nonprofit organization must include evidence ofits nonprofit status with the application. Any of the {following ts acceptable evidence. Check the appropriate box or complete the “Previously Filed” section, Whichever is applicable, Te) Areferonce to tne organization's sting inthe intemal Revenue Service's (IRS) most recent lis of taxexempt organi ® ‘Reapy of a currenty vai tntrnal 0) Aatement roma Sit sng boxy. Sate tony pine sharon conchae Os ‘establishes the nonproft status of the desctbodin secon S0ieK3) the IRs Case, Rovere Seis i ‘@ nonprofit status and that none of the net earings accrue jax exemplion corticate, General, of other appropriate State official apy on areas ans of wzaerten oso doce i cy Ci) Any ofthe above proot fora State or national parent and a statement signed by the parent ‘organization, ‘organization thatthe applicant organization isa local nonprofit afliate t¥an applicant has evidence of current nonprofit status on fle with an agency of PHS, it will not be necessary to file sir Previously Filed with: (Agency) lar papers again, but the place and date of filing must be indicated 00 (Date) INVENTIONS {this is an application for continued support, include: (1) the report of inventions concelved or reduced to practice required by the terms and conditions of the grant, or (2) 8 ist of in ‘already reported, or (3) a negative certification, EXECUTIVE ORDER 12372 fective September 30, 1983, Executive Onder 12372 Gtrgoveramenal Reviw of Federal Programs) dived OMB wo abolish OMB Circular” A95 and’ establish anew process. fot consulting with State and local elected officials on proposed Federal financial assistance. The Department of Health and Homan Services implemented the Exccutive Order through regulations at 45 CFR Part 400 (ater-governmental Review of Department oftealth and Human Services ‘and Activites). The objectives of the Executive Order are 10 (1) increase State Nexbiliy to design a consultation Process and select the programs it wishes to review, (2) increase the ability of State and local elected officials to tiflucace Federal decisions and (3) compel Federal official to be responsive to State ‘oncems, or explain the reasons ‘The regulations at 45 CFR Part 100 were published in the Federal Register on June 24, 1983, along with & notice identifying. the Departments programs that are subject to the provisions of Executive Order 12372. Information PHS" programs subject. to Executive Order’ 12372 is ‘also available from the appropiate awarding office, States in this program establish Sate Single Points of Contac (Shes) fo Cott und wage he trio Sad comes ‘on proposed Federal financial assistance Applicants shoul contact the Governor's office fr infomation regarding the SPOC, progam Selected for review, and th coaitaton (review) process dened By thei Stat, ‘Applicants are to cxtiy on the fe page ofthe SF-424 (anated) wether the equ fo a propram Core unde Excuoe Orlg 12372 and, where appropriate, wheber the Sate has been pivea pporanity 0 comment‘OMB Approval No, 348-0044 BUDGET INFORMATION - Non-Construction Programs Eee SatPagen ‘gt Estmatad Uobigaes Funds New Revised Budget ll Naber Fea NonFederd Fetal NonFoderd Tot 0 ®) 6 @ ‘ ® @ 1.SPRANS seniono | 5 $ meam |S $2542.00 2 co a 0.00 4, 000 tows som fs ois sano sams gan SSE) 8 Chet Cas Cores a a —, 5 - 4 Pesenel s sszian | 5 s $ 18212000 b. Fringe Benefits 13,400.00 13,400.00 Travel 600.00 6,600.00 Exiga 9987.00 sgen00 © Series nga 960.00 Contacte 00 ee) 40000 | sate h Ober 439350 43,985.00 \TealOfet Chas fumof =6 295420 00 0 0 29544200 nd Charges .00 k. TOTALS (sum of land 6) $205,442.00 $ 0.00 0.00 000 7. Program ince iS S$ | s 0.00 Suet fom (4) Frat Ce ttBS (deat ogra (acieteaea | Tos é s s $ soo 8 a rn 7) ft 0 12 TOTALS (sum of ines Sand 11) $ 00 Is om ls 0.00 00 Se eC eNaay Teath ‘Que ‘dQ utr eure 12, Fete Sammon [8 ars 8 azmy [spares [3 saateon 14 Naot 4.00 18, TOTAL (sumone f3and 1) S$ msuom js erga seznam a0 933800 Sa acuta Ua eat el eda ta ot sad setPagen TURE NOG FEROS) fi Feet {e) Seon jae (o}Fourth 18. Community-Based Abstinence Education Pagan s 23544200 [s soggzem |g ai4tTa00 Is t ‘8 # 5 5 5 5 28, TOTALS (sum tines 16-19) 29544200 ssoggzz00 $314,170.00 soon SECTION F- OTHER BUDGET INFORMATION 2, Det hares: 2. nie ages: 2%, Rena SF 78 PagetSole 3) eee INTERNAL REVENUE SERVICE DEPARTHENT OF “THE “ThE, Distrfet Director 112 Conmacce St., Dallas, 1X 75242 Person to Contact: Customer Survice Otviston Crleta Pragnaney Sarvians of Telephon Munbar Dupage County tne. (990 3a28-1940 G71 M. Cows Avenie Wentmont, TL 60sso-1330 Rafar Reply 4 Mall Cede 4949 DAL Dat May 27, 1997 Dasr Sir oe Madant Our eae do show that tha Criats Pragnangy Servioss of Uupage County, Ine.ts axampt fron Federal Incane Tax undar ection Bila K(3) af the Internal feveas Goda. This exemption wax granted January 1962 and remaina in full force aot effect. Contributions to your organization are deductible in the manner and to the oxtent provided by wactlon 178 of the cade Wa have clasalfied your organization as ona that 1s not a privats foludalian ulthin the meaning of wactlon GQ9¢a) af the Intarnal Ravens Goda ergantzation tn described tn section 17Q(bNIMAIYI) of the corte Yours LF gross racatats fer your organtzatlon reach $25,099 or mare, in any ona yaar, the orgnnization will be required to fla Form 990, Aelurn of Organization Exanpt From Income Tax. This totter may ba used le verify your tax-exempt status 7 Lf we may be of furthor aseistance, pleana canlact the persen uhosa nana and telephone number are shoun stave UW. Hann Chiat, Euployes Plans nd Exempt Organizations Cuslonar Service SwettonInternal Revenue Service Department of the Treasury P.O. Box 2508 Cincinnati, OH 45201 Date: July 10, 2002 Person to Contact: Pat Mahan 31-04019 Customer Service Representative Carenet Pregnancy Services of Dupage County, Inc. Toll Free Telephone Number: 671 N Cass Ave 8:00 a.m. to 6:30 pm. EST. Westmont, IL 60559 877-829-5500 Fax Number: 513-263-3756 Federal Identification Number: a Dear Sir or Madam: duis lelter is in response to your telephone request of July 10, 2002, for a copy of your organization's determination letter. This letter will take the place of the Copy you requested. Your organization is required to file Form 990, Return of Organization Exempt from Income Tax, only ifits gross receipts each year are normally more than $25,000. Ifa return is Tequired, it must be filed by the 15th day of the fifth month after the end of the organization's annual ‘accounting period. The law imposes a Penalty of $20 a day, up to a maximum of $10,000, when a return ie flea late, unless there is reasonable cause for the delay. ‘Al exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more Paid to each employee during a Gauendar year. Your organization is not fable for the tax imposed under the Federal Unemployment Tax Act [poners may deduct contributions to your organization as provided in section 170 of the Code, Bequests, legacies, devises, transfers, or gifts to your organization or for its use arc deductible for federal estate and Lift tax purposes if they meet the applicable provisions of sections 208% 2108, and 2522 of the Cade.BUDGET JUSTIFICATION - Non Construction Programs ‘SPRANS Implementation Grant CareNet Pregnancy Services of DuPage Year‘ Year? Personnel Program Director (FT) ye ke Program Directris a ful ime poston and wil oversee operations ofthe Absinence Education Program, She will market the program to schools, churches anda choo programs, Will oversee training of instructors and wil present to students. The| Director will, Supenise al staff and instructors Program Traine!Coordintor (FT) yo. be Program TrinerCoordnalris fl ime poston and wil be responsible in traning the instuctors as wel as comple statistical data om pre and post sures, Wil asst Dietor incoortnang athe speaking engagements in schools an wil expected to present in schools tthe need arises. Program Administrative Assistant (PT) by Program Administrative Assistant isa pattie poston. This person will manage all correspondence fr his program in tems of ying ing and preparing repos, Instructors (PT) @ Sp fo 200 classes bb he Instulors willbe on patie basis @ Sp for every presentation, Ther main responsibly wil eto teach the cuiclum aswel as encourage students fo jin he suppor group. ‘Binstuctrs needed. We estimate ere willbe about 200 sessions per eat Program Assistant (PT) @ $15 for 200 classes vb Yo Program Asians a parttime poston and wil asitin Keeping odern seins 2 well astand ot brochures, pre and post survey questions and ny oter materials hat he sldens wil equ ducing he sessions, {Oneeded and willbe paid @ Spy session, Support Group Coordinator PT) for tEhrsiveek @ hb io bb Supprt Group Corner wil be patie trstneek @ SH Tis postions the ont ln worker toprovde ongoing suppor to students who have chosen absinence and ten the pledge as wel as be avaiable to ans any quesins the students may have tere class presentations. Total Solas 152,200 16428860 Pant af Year3 *e be yb yy 119,075.06ile 6,400.00 6,490.00 6,400.00. sptlnta and fom sto, churches an ate-schoalproyas for Program Director and TrainerCoordinatr to meet wih staf of eflving: days 900.00 300.00 990.00 0 40.00 onc ana nd tanspoaton 000 wom 0.00 parson ennc0 wna 72000 2,200.00 2,200.00 2,480.00 4,600.00 8,600.00 4,880.00 Dana ate$299.99 each & Toner @ 49.99, One printer wil be in ther atthe Traine'Coordinatrs office. These printers willbe tralve Assistant's office and the support group fice, mory fax machine & toner n paper memory Fax Machine, This willbe plaoedin the office who wll oversee it use and wl send most of the faxes, SHARP AL-(55¢ (SHARP AL-1551) wil be in Administrative Assistants office whose brochures, fers and abstinence education program materials for ts 29451652 Telephone system hand se. The Direct, stucos/Supoot Group Coorinat’ fice wl each havea hoe gsiem wilbe placed in the Administ Assia fice, ital 298692 paced in the Adinsvatve Asian ofc ch 9 each for Director, TrainerCoortinaor, Adminitrative Assistant e Ofce shared by instructors and suppor group coordinator, ch Dann 9 ate 154.98 798.99 399.96 40.00 508.96 308.9623048 slacedin ha conference oom to be used by insur vig c8 education program, 5099 ct n the conference room for insbucor use or ung nstutr $9.99 Soren 198.99 499.99 168.99 agg ] 3098 'uctr taining and during abstinence education sessions tht wil 114.98 248.99 9,987.04 Dann tafe} 0, leaders quid and 20 student manuals. These wil be avlate when hey nea hem and willbe athe teneroorrlors fie, 5 parent books +35 paren! books wl be used bythe Director of epg who the ren presents manual hich willbe inthe TrnenCoordntors office. She wilbe f the manuals at al times, per book eat he Diet fice. due, tape, Fle Folders, loyees @ $75 each Baring) ta be used as an incentive for actively patpatng in the 25 @ 49999 each 375.00 395.00 23,200.00 7,720.00 3,200.00 300.00 24,000.00 1,759.96 60,949.96 24,000.00 7,200.00 3520.00 24,000.00 58,721.00 24,000.00, 7,200.00 3,870.00 300.00 24,000.00, 59,370.00asthe widest circulation reaching thousands of people. Ths will ij Everyone an equal so thal in return we can get the most qualified es to advertise youth rally in schools, churches ete, 106.7 the FISH @ $75 for 40 commercials end to vite prominent speakers like A.C Green or Ms Eka Harold ly which wil be held in May 2004, insurance ) Insurance, This is the estimated costo bit insurance based is for ongoing tasng ofthe tf. They wil ated seninars to bisissue of sinence education, This cosines tring land food Manuals { Manuals is calculated at 5% of the total ost Pace cl6 2,000.00 1,700.00 2,400.00 3,000.00 §,500.00 1,584.50 43,984.50 295,441.50 4,200.00 3000.00 22,880.00 15,000.00 2,880.00 4000.00 6,600.00 1560.00 63,540.00 309,621.60 3,795.20 2,200.00 3456.00 3500.00 7,920.00 1,560.00 5191520 314,170.02uaa LASER PRINTER poe ise ea pret ie office at work Ht dar: spit spends 18 1 sr x 600d, gah ST ‘output, PC and Mac se 1p patmance and lay You woud xe dept Bromers persona sty. bere to 15 PO was 200 x 600 0 1 ay th ie iu 8 ; : i eo Fo > en Li were, er ene pe ee Sen meme ee mente . ccs" Geman Stee A : 38 ‘CAOBGAAABA ‘aserdet 460000 (CSTAOA CHEW CSTRIA. OM Z2N ‘Sundar — Notineoded inex AC a sj oaneunga on caren fics Netneboesmbor AB x 6 eat ea Ee ft amaeee SS cium team ie tacoma . Ee aes Ee Se rome termes : | CaeAABA Laserdet 8550 CAVABA, CAISOA, CATSIA, CAIS2A ‘Standard 6" included in box ae x ‘BELF2A046-10-GLO TERE Printer Cable 10°, A-B Type ‘See page 29 for Laser Paper es Hee Ge Se arash Cio ie ERoees ues AMM staal cecay hit pl pe Spe st as 0p (scons pt ee) stds + iy neta eet ras Da sa uta a DN PRO) Pst THO ET Toe ghee a IKE Fak Doyo re tires hihi inate mg ‘anata tse? 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Pocket fits almost anywhere, 2x magnification. ame Mt ‘eseitin ay. SisSbesey" where Mie Shag ON suonewesald [eNsiA + Available via Catalog and Online only.Has 23- aumtuung 22430 H 560 SERIES 25" DEEP SONOMY VERTICAL FILES A. 2-DRAWER FILE Wet MICE Orson etter sie: 29 Wa 1s W250 dros: Osea Pay STSAOLAES" 0562-0 Ugh Gay SrS.resae: Ose? Back Ceca sie: ar We toy Waxes O denwtarr™ oss2cu Pay Sis-awsts- DH2CO Up Gay dnamne perc Bek 8. 4-DRAWER FILE emt Mice ossiition evten sue: serfie se wes Ost Pay Hesterass- 08649 Uh cay Maaaes: oso? Bek CEGAL Ste SMe eve Wires" o drefiorest” osetc uty Grovereee osuee-o | Ugtcay Sretrrase os6e? Back suse su suas 10499 rou ss ious ‘au biee ses ess ston Fuss ACCESSORIES. . OPTIONAL INTERCHANGEABLE CORE REMOVABLE LOCK ‘of fron-to-back fling per drawer. Standard drawer slides, spring-loaded follower block, optional interchangeable core removable lock ‘Optional 2-step hang rails make these files a great valve. Meets or exceeds ANSIBIFMA and ISTA petformance standard. Available in putty, gt ‘or black Covered by the HON limited Kfetime warranty. ea Designed to work with HON 370, HON 560 Series. and HON 1000 Series vertical fs. lent Mit ‘Descaion ue Seabvenr x Sealackre ee ‘OPTIONAL HANG RAILS Designed to work wih HON 560 Series and HOW 1000 Series ome Mit gaan ay. Hresees2s IDG tang ats cd Beaecesy aos iting att 2k Colors and Finishes HON ste! fie coirs match ‘or complement al HON see desks, steal seating, nd computer furnture Pty Black 0)aunyusng 22410 ‘BC SERIES BOOKCASES ‘radional square corners fra clean look. emt vaawocane newest" Baus" 18 Sy te-st= frees S aysasesst” acon On ieesst Saaaan 5 beuesst B auesot o henes 9 3794711 6 asec 8 8 B aeusett 5 mia a0 ape rane Fanteose aR7252 vanes an063 ta rants sen ain7263 rane ans ata tanwese vaneose tanta vas Deswien wea 2st 3 gh 3 Sees Se hi sete tions eh 2 Hoh 6 Steves Beg Sees ar igh 2 ses ‘seg shes Se oh Sees frig s tenes Sr iign eSe me Peg sees gh 2s 36 Mon snows Sep shes Sen 6 tees Beg Shes sngse 3a sass sess yao Sess sau ans Sense sss feass at WOOD VENEER BOOKCASES ‘Ghoose traditional square comer or contemporary radius cc acon Avaible in mahogany medium oa, of walnut vent $e tick, high-density patleboard constrcion with dawe and cam-ook fs ener for easy assembly. hele cust ic intervals, Al bookcases measure 3° Wx 12 O. ‘Assembly service avaiable (not included) 'B, RBC SERIES BOOKCASES Designed with graceol radius comers tor a smaoter lok. fame Mt ‘esclian Marocan sy Susaerer: wanna 2 Ngh 2S B Sloaceasne azusz I MON SN Seana tanaeane SH 4 Souk B Siosecast: rarasoz coh 3 Seles S Sencar yanaree 72 Han 6s Spaces arava | UMQN 7 Shel: iMeo}ow OnK ts Sroeeyate ARQ. 20 Hh 2S Bayer iano Se Han3 Shes 5 Soseceor: taraens 48 High Shes B Sareea: wos toh Shes G Sypseeart’ wararass 72 HON 6h 15 Sipasscoors tana) BC HGRT Stes wa fs Waeeres wasnt «20 High 7 Shes 5 yea fhe apes anaease roves tasers varaaiee Se ingn 3s 2 gh & Stes hgh Sees esrATTACHMENT G KEY PERSONNEL FORM (Supplement to Section F of Budget Form 424A) (Note: This form is pending OMB approval) ‘No. Monts TOTALS AMOUNT NameanpPosirionTimut | Anwuarsatany | NG oes | v4 tiaae | Tas Awoy Q) Q) Q) (4) Barbara Singer 43,000 . 15% $0 Executive Director Ellen McInerney 35,000 12 100% 35,000 Director, Abstinence Education Program Vacant 32,000 12 100% 32,000 Trainer/Coordinator Vacant 21,120 12 60% 12,672 Administrative Assistant Need additional 10 40,000 Instructors Need additional 10 24,000 Assistants Vacant 21,120 10 40% 8,448 Support Group Coordinator Grant Specialist 32,000 12 10% 0 : —{ tie 7 FRINGE BENEFIT (Rate 20%) ones tow | $ 152,120‘OMB Approval No. 0549-0040 ASSURANCES - NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for eviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and ‘eviewing the collection of information. Send comments regarding the burden estimate or any other aspect of tus conneton et Information, incusing suggestions fr reducing ths burden, t0 the Offce of Management ond Badges Papermen Reckone Project (0948-0040) Washington, DG 20508. a LEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. if you have questions, Please contact the awarding agency. Further, certain Federal awarding agencies may require applicants 10 ‘certify to additional assurances. if such is the case, you will be notified. As the duly authorized representative of the applicant | certify that the applicant: 4. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure Proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, ‘access to and the tight to examine all records, books, papers, or documents related to the award: and will establish a proper accounting system in accordance with generally accepted accounting ‘standard or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or ‘organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes ‘oF regulations specified in Appendix A of OPM's Standard for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685- 1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabiltation Act of 1973, a5 amended (29 U.S.C. §§794), which prohibits discrimination on the basis of handicaps; (d) the ‘Age Discrimination Act of 1975, as amended (42 UIS.C. §§6101-6107), which prohibits discrimination (on the basis of age; (@) the Drug Abuse Office and Treatment Act of 1972 _(P.L. 92-255), as amended, relating to ‘nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ec-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title Vil of the Civil Rights Act of 1968 (42 U.S.C. §§9601 et seq.), as amended, relating to non- discrimination in the sale, rental or financing of housing: (j) any ‘other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and () the requiremenis, of any other nondiscrimination statute(s) which may apply to the application, Will comply, or has already complied, with the Fequirements of Title ll and. lil of the Unifonn Relocation Assistance and Real Property Acqui- sition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a resut of Federal or federally assisted programs. These Fequirements apply to all interests in real_ property ‘acquired for project purposes regardless of Federal Participation in purchases. Will comply with the provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose principal ‘employment activities are funded in whole or in part with Federal funds. ‘Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333), regarding labor standards for federally assisted construction subagreements, tna Far 448 (Ror?) Prost by OMB Cor 0k10. Will comply, if applicable, with flood insurance Purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973. (P.L 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 (or more. 14. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of _ environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11814; (b) notification of violating facilios Pursuant to EO 11738; (c) protection of wetland pursuant to EO 11990; (d) evaluation of flood hazards in floodplains 'in accordance with EO 14988; (0) assurance of project consistency with the approved ‘State_management program. developed under the Costal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §87401 et seq); (g) protection of underground Sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as ‘amended, (P.L. 93-206) 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq) related to Protecting components or potential components of the national wild and scenic rivers system. 13. 14, 15, 16. 17, 18. Will assist the awarding agency in assuring ‘compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 US.C. §470), EO 11593 (identification and protection of historic properties), andthe Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§ 469a-1 et seq). Will comply with P.L. 93-348 regarding the Protection of human subjects involved in research, development, and related activities supported by this award of assistance. ‘Will comply with the Laboratory Animal Welfare Act of 1965 (PL. 89-544, as amended, 7 US.C. §§2131 et Seq) pertaining to the care, handling, and treatment of warm blooded animals, held for research, teaching, or other activites ‘Supported by this award of assistance. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead based paint in con- struction or rehabilitation of residence structures. Will cause to be performed the required financial ‘and compliance audits in accordance with the Single Audit Act of 1984. Will comply with all applicable requirements of all other Federal laws, executive orders, re- gulations and policies governing this program. SIGNATURE OF AUTHORIZED, CERTIFYING OFFICIAL afiilara ap? THLE EXECUTIVE DIRECTOR "APPLICANT ORGANIZATION CARENET PREGNANCY SERVICES OF DUPAGE DATE SUBMITTED 1-23-04 5-426 (Ro. 757 BakPHS-St61-1 700) Page 7 ‘OMB Approval No, 0920-0028, CERTIFICATIONS 1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION The undersigned (authorized official signing for the applicant organization) certifies to the best of his or her knowledge and belief, that the applicant, defined as the primary participant in accordance with 45 CFR Part 76, and its principals: (@) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal Department or agency; (®) have not within a 3-year period preceding this Proposal been convicted of or had a civil Judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes ot commission ‘of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, ot receiving stolen property; (©) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with com- mission of any of the offenses enumerated in Paragraph (b) of this certification; and (@)_have not within a 3-year period preceding this application/proposal had one or more public ‘transactions (Federal, State, or local) terminated for cause or default. Should the applicant not be able to provide this certification, an explanation as to why should be placed after the assurances page in the application package. ‘The applicant agrees by submitting this proposal that it will include, without modification, the clause titled "Certification Regarding Debarment, Suspension, In eligibility, and Voluntary Exclusion—Lower Tier Covered Transactions" in all lower tier covered wansactions (ie., transactions with sub- grantees and/or contractors) and in all solicitations for lower tier covered transactions in accordance with 45 CFR Part 76, 2. CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS ‘The undersigned (authorized official signing for the applicant organization) certifies that the applicant will, or will continue to, provide a drug-free work- place in accordance with 45 CFR Part 76 by: (@) Publishing a statement notifying employees that the unlawful manufacture, distribution, dis- Pensing, possession or use of a controlled substance is prohibited in the grantee’s work- place and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an ongoing drug-free awareness program to inform employees about-~ (1) ‘The dangers of drug abuse in the workplace; (2) The grantee’s policy of maintaining a drug-free workplace; (@) Any available drug counseling, rehabil- itation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations ‘occurring in the workplace; (©) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by Paragraph (a) above; (d) Notifying the employee in the statement re- quired by paragraph (a), above, that, a a condition of employment under the grant, the employee will (1) Abide by the terms of the statement; and 2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; (©) Notifying the agency in writing within ten calendar days after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction, Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federal agency has designated a centralPage 18 point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; (© Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (4) (2), with respect to any employee who is 50 convicted (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, a5 amended; or @) Requiring such ‘employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (8) Making a good faith effort to continue to maintain a drug-free workplace through imple- mentation of paragraphs (a), (b), (c), (4), (e), and (f). For purposes of paragraph (e) regarding agency notification of criminal drug convictions, the DHHS has designated the following central point’ for receipt of such notices: Office of Grants and Acquisition Management Office of Grants Management Office ofthe Assistant Secretary for Management and Budget Department of Health and Human Services 200 Independence Avenue, $.W., Room 517-D Washington, D.C, 20201 3. CERTIFICATION REGARDING LOBBYING Title 31, United States Code, Section 1352, entitled "Limitation on use of appropriated funds to ine fluence certain Federal contracting and financial transactions," generally prohibits recipients of Federal grants “and cooperative agreements from using Federal (appropriated) funds for lobbying the Executive or Legislative Branches of the Federal Government in connection with a SPECIFIC grant or cooperative agreement. Section 1352 also requires that each person who requests or receives a Federal grant or cooperative agreement must disclose lobbying undertaken with non-Federal (non- appropriated) funds. These requirements apply to grants and cooperative agreements EXCEEDING ‘$100,000 in total costs (45 CFR Part 93) The undersigned (authorized official signing for the applicant organization) certifies, to the best of his her knowledge and belief, that: (1) No Federal appropriated funds have been paid ‘or will be paid, by or on bebalf of the under- PHS 5161-1700) signed, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, "and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2) Ifany funds other than Federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or ‘employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. (If needed, Standard Form-LLL, "Disclosure of Lobbying Activities," its instructions, and continuation sheet are included at the end of this application form.) @) The undersigned shall require that the language of this certification be included in the award doc- ‘uments for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shal certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was _made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 4, CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA) ‘The undersigned (authorized official signing for the applicant organization) certifies that the statements herein are true, complete, and accurate to the best of his or her knowledge, and that he or she is aware that any false, fictitious, or fraudulent statements or claims may subject him or her to criminal, civil, ot administrative penalties. The undersigned agrees that the applicant organization will comply withthe Public Health Service terms and conditions of award if a grant is awarded as a result of this application.PHS-S161-1 (700) 5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103-227, also known as the Pro-Children ‘Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned ‘or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, ‘education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee, The law also applies to children’s services that are provided in indoor facilities that are ‘constructed, operated, or maintained with such Federal funds. The law does not apply to children’s services provided in private residence, portions of facilities used for inpatient drug or alcohol treatment, service providers whose sole source of applicable Federal funds is Medicare or Medicaid, or facilities where WIC coupons are redeemed. Page 19 Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. By signing the certification, the undersigned certifies that the applicant organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. ‘The applicant organization agrees that it will require that the language of this certification be included in any subawards which contain provisions for children’s services and that all subrecipients shall certify accordingly. ‘The Public Health Services strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of tobacco products. This is consistent with the PHS mission to protect and advance the physical an mental health of the ‘American people. ‘SIGNATURE OF AUTHORIZED CERTIFYING OFFICAL Tite EXECUTIVE DIRECTOR "APPLICANT ORGANEATION 7” (7 CARENET PREGNANCY SERVICES OF DUPAGE ‘DATE SUBMITTED 171304Preprancy Counseling Center, 4A Crisis Pregnancy Center “ject Name: Worth the Wait Application Table of Contents 1. Project Abstract. PROJECT SUMMARY. I. Description of Need PROBLEMS REQUIRING A SOLUTION CURRENT ACTION BEING TAKEN. IH, Project Description. OVERVIE! OBJECTIVES... Principal Object Subordinate Objective: CURRICULUM SUMMARIES... LOGIC MODE! APPROACH. 2005-2006 Timeline. EVALUATION... RESULTS OR BENEFITS EXPECTED. SUPPORTING DOCUMENTATION. GEOGRAPHIC LOCATION. . STAFF AND POSITION DATA .. PLAN FOR PROJECT CONTINUANCE BEYOND GRANT SUPPORT .. ORGANIZATIONAL PROFILES IV. Budget Narrative/Justification.. PERSONNEL _CONTRACTU: FRINGE BENEFITS. __YEAR ONE (travel, equipment, supplies, contractual and other) INDIRECT CHARGES. PROGRAM INCOME APPENDIXPregnancy Covaseing Center,” %BA Crisis Pregnancy Center ‘rojent Name: Wort the Wait LETTER OF TRANSMITTAL APPLICANT ORGANIZATIONA NAME Pregnancy Counseling Center, Ine. DBA Crisis Pregnancy Center CONTACT PERSON Mechele LaBrie FUNDING OPPORTUNITY TITLE Community-Based Abstinence Education FUNDING OPPORTUNITY NUMBER HHS-2005-ACF-ACYF-AE-0099 CFDA NUMBER 93.010Voluntary Assurance As the authorized individual signing this grant application on behalf of Pregnancy ‘Counseling Center, Inc. DBA Crisis Pregnancy Center, [hereby attest and certify that Pregnancy Counseling Center, Inc. DBA Crisis Pregnancy Center, while administering Federal and/or non-Federal funds under the Community-Based Abstinence Education Program, will not provide to an adolescent and/or adolescents any other education regarding sexual conduct, except that, in the case of an entity expressly required by law to provide health information or services. In this circumstance, health information or services (expressly required by Jaw) must be conducted in a different setting—either in time or place—than where and when the abstinence-only course is being conducted. Mew IZ, O57 Date Stun W. Wren Printed Name of Authorized Individual Brel Signature of Authorized Individual APPENDIX "3" ~78-CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103227, Part C Environmental Tobacco Smoke, also known asthe Pro Children Act ‘of 1994, requires that smoking not be permed in any portion of any indoot routinely owned or Tease or contracted for by an entity and used routinely or regularly for provision of health, day care, education, of library serves to children uader the age of 1, ifthe services are funded by Federal programs ether directly r through State or local governments, by Federal grant, ‘contract, loan, or loan guarantce. The law does not apply to children's services provided in private residences, facilities funded solely by Medicare or Medicaid funds, and portions of facilities used for inpatient drug or alcohol treatment. Failure to comply with the provisions of the law may result in the imposition of a civ monetary penalty of up 10 $1000 per day andr the imposition of an administrative compliance order onthe responsible enity. By signing and submitting this application the aplicant/rante certifies that it will comply with the requirements ofthe Act. ‘The applicand/granie Further agres that it wll require the language of this certification be included in any subawards which contain provisions for the children's services and that all subgrantees shall ery accordingly APPENDIX "J"(CERTIFICATION REGARDING LOBBYING Cerieaton for Contacts, Gans, Lom am Coopentive Apeements The undessgnedceifs, he best of is or her ved and ei, at (1) No Federal appropiate an have been pai ox wil be pl yom tha of he designe ay ene Sox efaencig or tenting wo inlcnc noi or employe of a trney, » Memes of Congres malic ot “employe of Congres or employer of Member of Congres conection wth te wari fy Fetes ‘rac he making of any Fedral rm the aking of oy Fee ln, he ening oa any coopeare ‘aecnent andthe extenson, cominton, rescaled, or moctin of ny Fede ac a, Ian o cooperative agement 2) any is ter hn Feral apropitdfnds have ben pi wl be pido any person fencing ot tempting flees an office or epee of any ancy, a Men of Congres, an ofc er employe ot Conares, ra employe os Mere of Congres conection wi is Federal contact, rant a or ‘oopetve agree, he undersigned shal camped se Suadard Frm chr Fm © Report Labbyng in corde wiht ncone (0) The undersigned stall rue tthe ngage of hs certo be incised nthe aad document fl ‘subavads al ers (cdg scons supa, tnd cone unde roars an coopera ‘agreement and tht al sabvecipicts sal ecru and dase scadgy. This atieston sera ‘presentation of it won whic lance was laced When Ws econ wee made ence in. Sbmision ‘ofthis cerificaon is prerequse fr making entring instream ips ty secon 135 ae US Cove. Any person wt asi the reuedertcaton shal be yet on pay of rates ah 510000 and ax more an $10.00 for ech ach fre Stemeal or Loan Gurates Lasn eae ‘The unenignd snes, the best of ier hr knowledge tebe, at ‘any fds have ben pido wil be pid any pen frist or sesing nen once ot mpage of uy agocy. Member of Congres an ofc er nploesof Congreso cmp ots Meer ‘of Canes nconecin with hs commstet proving he Unied Sato nro poe aoa, he ‘desc shal come ad subant Sundard Form LLL,“ Dischne Frm to Report cbiying nscerance ih nsrocsons. Submis of ts Stement ia preseuste fox making octagon, ign by scion 1392 ie 3, US. Cae. Ary pion who sole the eqused semen shal be ject hi penny a oc estan 310,00 and not more han 510,00 fr ach uc fare Shaan a4 CoMna HA Conley aa DEO Crisis Drogo core APPENDIX "DISCLOSURE OF LOBBYING ACTIVES oe contd pg ans puss s1 USC 182 a caer cee eee ne : Fpearrcaarnms — een ecm oomcocan [faye ainey Fes ee freee aye a creed tert = Satan ee fa a ping Gap Ey aT a ESS Gee ene eee a es resis - Bog Berk Fey | crate ree 2 _ aS cnmetibees Faeries Youth Sevvices peal oma Taman Services) COA Woe, Haprcane 3. O1O Jf Feierai Acton namber, WUS-2005 -ACE- ACHE Ae: on [8 Award Amoi, Frown: s \0-. Name and Adreas of Lobbying Registrant \Winaiids, ast name, est name, ‘individual Pertorng Services (cag aes F ‘iterent fom Wo. 108) aoe See leprae 200 Beer erty A _H950% Se Eo a nT bee SL Jeetene swe Laces [rise Lees Div [Telephone No: 28 F26 St4'7 dave: Jaen lle) | Federal Use Oniy: "haart een ‘SueFom feo. APPENDIX -75- age0, Program develop une the Costa Zone Management ett 872 (18 USC. 64451 ot soa) caremty of Feserl scons o Sate (Can A inlomertaen Pane liner Sector 176) ete Coan Al Ac O05, tended (2 USC 847401 e1 seq): @) prolacten Underground souces of aieking wale under be Ste Dansing Wat At ef 1974 a8 mended i. 29-523) snd) protection of orsangored spaces under the Endangure Speoes Ac f 1573, a8 arandad QL $3 205) 12 WH comply wat we Wd and Scone Foes Ae ot 1968 (16 USC 951271 et aq) ree pote Wt ast ne awarrn agency asutagcompance ‘wth Seaton 105 of fu Natoal Heke Presse ‘aol 1966, as nerd (16 US.C. $470, £0 T1550, (Renttaon ad prtecton of ses properties nt te ‘Htc Preseveion Act ot MA IBUSC Sata: teen) -74- bal dbo Crisis Prey Gntur [SRATORE OF AUTHORED CERTFTRG OFFER pce Exec. Oivectorr ean ORATOR [one samae Pregnancy @unseling Carr APPENDIX Sand Fee 8 i FA, waeSECTION C- NON FEDERAL RESOURCES eae ran Siren | Sais [OG Saree] TOTS a ook s Is ls el fe fn i Tora mars) ee | SECTION D- FORECASTED CASH NEEDS: ae | wee aS So =o eee $321,359 baz gan thoy 939% +b 92,3394} fe en Fetal — = — == ~ 5. TOTAL (sum av tines 19 ana 14) 31,357 + Qo 33971, w57 Ly ILENGZ 334s SECTION AUOGET ESTIMATES OF rebenA. unos necoea rok aaLancx or Ga hoses a a TURE RWG PeRIODS eens | ra iene tates [Bian Caacaben P37, 5877637) 257% 371 365 i - . | fa. TOTAL ¢sum of nes 16-19) 377 357% ik 37/357" RAAB SEGnon F-oTHER UOGET mromaaTion fat Deed Charges _— [P2 indect Charges: = [23. Remarks: ~ Authorized for Locat Reproduction. a ‘Sue For A hey P47 ged -73- APPENDIX "guPrognancy Counseling Cente, DBA Crisis Pregnancy Center , Project Name: Wont the Wait I. Project Abstract PROJECT SUMMARY. The project for which funding is sought is ongoing abstinence education for Northern Nevada’s youth ages 12-18 through the Worth the Wait (WTW) program. WTW has been bringing the abstinence message to Northern ‘Nevada youth for 11 years. In order to encourage youth to make the healthiest choice regarding their sexual behavior by abstaining from sexual activity until marriage, WTW offers individual and group abstinence education, counseling and mentoring. By collaborating with Eagle Valley Middle School, Carson Middle School, City of Reno Youth Service Department, State of Nevada Health Division, and Local Pastors and clergy, we will achieve our goal of encouraging abstinence until marriage throughout Northern Nevada. WTW currently has 9 trained speakers. WTW will continue to recruit speakers of different nationalities and gender to go into the community with cultural competency and sensitivity with the abstinence message. After speakers are trained there are a number of guidelines in place to ensure that the quality and integrity of the program stay intact. In an effort to broaden awareness and interest of the abstinence message we will advertise in a number of different venues such as movie theatres and taxi cabs. These advertisements will also generate more interested speakers for the abstinence message. and ideas and suggestions on how to encourage abstinence to theif requesting $371,357.64 for the first year to fund the WIW Abstinence Education program.Pregnancy Counseling Cee, Crisis Pregnancy Center {ect Name Werth the Wait IL Description of Need PROBLEMS REQUIRING A SOLUTION. In Northen Nevada, WTW is the only provider of abstinence-only education. Although there are programs in place in school districts such as Washoe County which promote abstinence, these programs also ‘support and provide information on contraceptives. Because Abstinence is the only 100% effective way to prevent teen pregnancy, the spread of Sexually Transmitted Infections, is crucial that Abstinence is and depression associated with teen sexual activity, presented to Northern Nevada’s teen population as the only 100% successful way to avoid these things. There are a number of statistics which demonstrate the need for more widespread abstinence-only education in this geographic area. The following information depicts this significant need: © In 2003, 46.4% of Nevada High School students stated that they had engaged in sexual intercourse (Nevada Youth Risk Behavior Survey [NYRBS], bttp://health2k state.nv.us/nihds/yrbs/sex/1.htm). ‘© Nationally, 14% of high school students report having had four or more sex partners, For High School students in Nevada, the total percentage is 19%, ‘5% higher than the national average (2003 NYRBS). © The Nevada State Health Division Bureau of Family Health Services (NSHD) stated that Nevada’s Hispanic Teen Birth Rate aged 15-19 numbered 111.08 per 1,000 females in Washoe County, signifying a need for abstinence education in the Hispanic community (http://health2k state.nv.us).Pregnancy Couseling Cent DBA Crisis Pregnancy Center Pret Name: Worth the Wait «According to the NSHD, Approximately 4 in 10 girls become pregnant at least once before age 20 (http:/¢health2k state.nv.us/cab/factsandstats.doc). © According to the NSHD, teen childbearing costs taxpayers and estimated $6.9 billion a year (http://health2k state.nv.us/cab/factsandstats.doc). This is $6.9 billion a year that could be saved if all teens were committed to abstinence ‘until marriage, the only 100% effective way to prevent pregnancy. «According to the NSHD, on any given day in Nevada 13 girls are pregnant, half of them between the ages of 10 and 17 (http://health2k state.nv.us/cab/nevadafacts.doc). + From January 2004 through December 2004 the Crisis Pregnancy Center of Reno/Sparks (CPC) had 1,237 new clients secking pregnancy tests. Of these new clients, 31% were Hispanic, comprising the largest clientele besides Caucasians (45%). For this reason, WTW is ensuring that the Hispanic ‘community is not overlooked in their project plan. A study from the Heritage Foundation has found that teens who have had sexual intercourse are more likely to feel depressed and suicidal than teens that have not become sexually active (http://www heritage.org/Research/Family/eda0304.cfim). ‘© 1n2000, The National Campaign to Prevent Teen Pregnancy ranked Washoe County, Nevada (the most populated county in Norther Nevada) 259 in the country for percentage of live births being born to teenage mothers, the highest percentage being ranked 458 (http://www.teenpregnancy.org/resources/data/pdf/CountyTBAIpha pdf) . 5+Pregnancy Counseling Center, Crisis Pregnancy Center ject Name: Worth the Wait + According to the Center for Children in Poverty, National Longitudinal Survey of Youth, and the National Center on addiction and Substance Abuse at Columbia University, teen parents (1) are less likely to finish high school, and (2) cam less money than people who wait until they are 20 to have children. The babies bom to teenage mothers (1) are more likely to be premature and to be low birth weight and (2) are more likely to repeat grades in school or to drop out altogether. The daughters born to teen mothers are more likely to become teen ‘mothers themselves and the sons are more likely to go to prison, and have a higher risk of smoking, drinking, and drug use (http://www.necp.org/, http://www.bls.gov/nis/nlsy97.htm, and http://www.casacolumbia.org) ‘© As depicted in the following graph, the State of Nevada overall experienced a decrease in teen pregnancies between 1998 and 2002. However, Washoe County, the most populated county in Northem Nevada, evened out to a near plateau as the rest of the state continued to decline, suggesting a greater need in this area for abstinence education (http:/fhealth2k state.nv.us/nihds/stats/teenpreg204.pdi).. -6-Pregnancy Counseling Centex DBA Crisis Pregnancy Center |Proect Name: Worth the Wait ‘© The number of live birth and birth rates among unwed teenage girls in Nevada in 2003 show a strong need for abstinence education. The following is breakdown of live births and birth rates among the people groups targeted in this grant (http:/health2k.state.nv.us/nihds/measures/teen_preg/long_form-html) Live Birth and Birth Rates Among Unwed Nevada Youth, 2003 Ethnic Group & Age Group | Number of Live Births | Birth Rate Per 1,000 Females All, ages 10-17 1,061 8.57 All, ages 15-19 2,699 35.14 Hispanic, ages 10-17 378 16.11 | Hispanic, ages 15-19 1,276 57.81 ‘Native American, ages 10-17 | 10 499 ‘Native American, ages 15-19 | 45 35.04 -7-‘Pregnancy Counscing Contr, In A Crisis Pregnancy Center {est Name: Worth the Wait Efforts by Abstinence-Plus programs (abstinence information plus contraceptive information) to address these issues are and have been inadequate because, as stated before, Abstinence is the only 100% effective way to avoid the detrimental consequences of sexual activity demonstrated in the above statistics. WTW, as the only Northern ‘Nevada provider of abstinence-only education, addresses these issues and discusses successful methods for avoiding activities that may prove detrimental physically, emotionally and financially. However, WTW is currently only able to reach two of ‘Northern Nevada’s counties. Therefore, the need remains for other Northern Nevada youth ages 12-18 to be reached with this message. CURRENT ACTION BEING TAKEN. _ WTW actively brings the abstinence message to schools and youth programs in the Washoe and Carson counties of Northern ‘Nevada. The success and positive response to WTW in these areas is encouraging, but there are still abstinence education needs that remain unmet in Northern Nevada. WTW, as the only provider of Abstinence-only education in this area, desires to expand its area of coverage to include six additional counties. WTW also desires to update the technology utilized currently, transitioning from overhead projector technology to the use of laptop computers and digital projectors, to increase the mobility of the program. Please ‘see “Approach” on page 15 for further details.Pregnancy Counssing Cent; DBA Css Pregnancy Center {> Project Name: Worth the Wait IIL Project Description. OVERVIEW. The primary method of achieving the goals of the WTW (Worth the Wait) Abstinence Program will be training volunteer speakers to go into their communities to present the curriculum directly to the youth in a variety of settings, including schools, extracurricular groups, Boys and Girls clubs, church groups, and other youth groups. Representatives of each of these venues have expressed a need for and interest in abstinence-only education from WTW. WTW Coordinators will be actively seeking people to recruit volunteer speakers from all areas within the desired area of coverage. Coordinators will partner with pastors and clergy for referrals to recruit these speakers. In the recruiting process, WTW will seek qualified people from all races and both genders. Efforts will be made to recruit speakers who have had experience with or are equipped to ‘work with adolescents. A thorough application process allows Coordinators and the Program Director to assess this quality, and also allows them to ensure that all volunteers and staff of WTW support and live an abstinent lifestyle unless married. This is critical, ‘as many of the speakers and staff will already be known throughout their small communities. OBJECTIVES. All objectives listed are followed by the coordinating defining components (A-H) of Abstinence Education. Principal Objective: * Individuals will be equipped with strategies to culti (Witt emphasis on marriag6 and reserving sexual expression for the mariage relationship. (A-H)Pregnancy Counseling Center, In” Crisis Pregnancy Cente ‘est Name: Wort the Wait Subordinate Objectives: Students will articulate goals and the connection between healthy choices and the attainment and protection of these goals (A). Students will understand the basic characteristics of emotional maturity and decision-making (A, G). Students will be introduced to a comprehensive definition of abstinence (B). Students will discuss and analyze the different motives a teen might have for choosing sexual expression. Students will articulate the possible results of sexual expression and analyze the impact these consequences may have on future goals (A, C, E, F, H). Students will understand the stages of sexual expression, from holding hands through intercourse, and contemplate their personal sexual boundaries (G). Students will describe the characteristics of a best friend relationship and the difference between emotional intimacy and sex. Students will be introduced to the five levels of intimacy and the benefits of sexual expression being reserved for the context of lawful marriage (D, E). Students will compare and contrast other-centered love with self-centered love (love vs. infatuation) (A, D). Students will understand how to give an appropriate refusal message, which includes a personal boundary (G). (CURRICULUM SUMMARIES. To achieve these objectives, WTW (Worth The ‘Wait) uses the SHARE (Sexuality, Health, and Relationship Education) curriculum. -10-Pregnancy Counseling Centx_ DBA Css Pregnancy Center {Project Name: Worth the Wait SHARE has been developed by Life Choices, located in the State of Washington. SHARE has been approved through the Abstinence Clearinghouse, the national grantee to ‘ensure Title V programs’ faithfulness to the A-H requirements. SHARE has proven its effectiveness to encourage healthy decision-making in adolescents in the Washington area since 1987. They speak to 14,000 students a year and have continued to grow in national and international influence. SHARE/Life Choices has over 105 national affiliates, WIW being one of them. SHARE is an interactive, multi-media approach requiring much analytical thought, All presentations use a directive approach, meaning that an argument for the validity of abstinence until marriage is built step-by-step, letting the listener interact and draw his or her own conclusions. The desire is not to dictate to the listener or tell him or her what to think, but to present information and facts in a logical manner, which will allow them to synthesize that information into reasonable, healthy decisions. WTW utilizes the SHARE curriculum because it uses an approach to adolescents in an age-appropriate manner that meets the needs of a diverse audience. It is interactive, fun, and deals with core issues surrounding sexuality, including the harmful consequences of unplanned pregnancies and contracting a sexually transmitted infection. Most importantly, SHARE offers adolescents practical information on how alcohol and ‘drug use increase the likelihood of sexuality, and on how to reject sexual advances. SHARE promotes sexual abstinence and does not promote the use of or provide information on contraceptives. ‘The particular SHARE curriculum currently utilized is entitled “Relationships 201” and is designed specifically for 6" through 8" grade students. “Relationships 201” is designed -i-Pregnancy Counseling Center, Ini Crisis Pregnancy Center fect Name: Worth the Wait to be presented across a two-day period in the traditional secondary school classroom. In its entirety, it is most appropriate for 7" and 8" grade students. In the interest of time constraints and age-appropriateness, “Relationships 201” has been edited to be suitable for a 1-day (1 hour) 6" grade presentation, as well as a separate 1-day (1 hour) 7" and 8* grade option. These choices allow teachers/leaders to request the presentation which best suits their particular group. Both the 1-day 6® grade and the I-day 7" & 8" grade Presentations are derived from and contain only information that is also present in the complete 2-day “Relationships 201” curriculum. In addition to these presentations, WTW. has translated “Relationships 201” into Spanish to be able to better provide abstinence education to the Hispanic community. Below is a listing of “Relationships 201” ‘components and their corresponding characteristics to Section 510 A-H Guidelines. A=H Guidelines ‘SHARE Relationships 201, (A) Health gains-social and psychological Goals/Maturity/Levels of Intimacy (B) Abstinence is expected standard for Definition of Abstinence school age child (C) Abstinence is the only certain way Possible Risks to avoid pregnancy and STD's (0) Fait Levels of Intimacy/Marriage ‘E) Sexual activity outside marriage is Risks/Level of Intimacy \ likely to have harmful psychological Risks -12-Pregnancy Counseling Center) DBA Crisis Pregnancy Center Project Name: Worth the Wait likely to be harmful to the child, parents and society. (G) How to reject sexual advances, vulnerability Boundary Setting/Refusal Skills ‘when using drugs and alcohol (H) Importance of attaining self-sufficiency Risks/Levels of Intimacy before engaging in sexual activity. Please see Appendix “G” for detailed outlines of each of the 3 versions of Relationships 201 used by WIW. WTW plans on expanding the curriculum utilized to include SHARE’s “Relationships 501” curriculum. “Relationships 501” is designed specifically for grades 10-12 and is organized into a 5 class period presentation. This will take place in the second and third ‘year of the grant. The first year we will concentrate on getting the abstinence message to the middle schools in Regions 1 through 5, which will be defined later in the budget narrative. “Relationships 501” addresses 4 cultural beliefs, the nature of misconceptions, and guides students through weighing these cultural beliefs for validity or invalidity. This structure allows for a mature look at decisions facing 10°-12" graders and equips these youth with information and tools for making healthy choices, with a focus on sexual abstinence until marriage. In the timeline that follows in the “Approach” section of this grant, the Program Director is scheduled to attend a training in this curriculum. After attending this training, the Program Director will be equipped to train other staff and volunteers in this curriculum. By adding “Relationships 501” to the presentations offered -13-Pregnancy Counseling Center, tn) Crisis Pregnancy Center ‘ject Name: Worth the Wat by WTW, a broader teen audience will be reached with age-appropriate materials. Below is a listing of “Relationships 501” components and their corresponding characteristics to Section 510 A-H Guidelines. A=H Guidelines (A) Health gains-social and psychological (B) Abstinence is expected standard for school age child (©) Abstinence is the only certain way to avoid pregnancy and STD’s (D) Faithful monogamous marriage is standard for human sexual activity (&) Sexual activity outside marriage is likely to have harmful psychological and physical effects (F) Bearing children out of wedlock is likely to be harmful to the child, parents and society. (G) How to reject sexual advances, vulnerability when using drugs and alcohol (H) Importance of attaining self-sufficiency ‘before engaging in sexual activity. ‘SHARE Relationships 501 History of Societies and Sexuality Definition of Abstinence, Sexual Expression, and Intimacy History of Societies and Sexuality Foundations of Relationships Characteristics of Marriage Marriage and Cohabitation Statistics History of Societies and Sexuality Progression of Sexual Expression, Boundary Setting Discussion of Whole Person, History of Societies and Sexuality Please see Appendix “G” for a detailed outline of Relationships 501.Prepnancy Counseling Cee DBA Crisis Pregnancy Center Projet Name: Worth the Wait LOGIC MODEL. The following logic model illustrates the proposed activities to accomplish the project’s goal. [ Prose I ‘Gutcome ‘Resources Activities Outcomes Goals Staff Provide -Reduction in Increase the ‘Atstinence-only teen(15-19 | number of -Volunteers: education and years old) live Northern Nevada mentoring to birth rate from | youth committed “SHARE ‘Northern 35.14 per 1,000 | to abstinence (Sexuality, Nevada's ten %025.14 per | until marriage. Health and (ages 12-18) 1,000 Relationship | population “Abstinence Education ‘curriculum (Curriculum: Individual ~~ Reduction in ‘taught in all abstinence the amount _| midle schools Speaker counseling Nevada high Evaluation & school students | -Increased Student Education of whohave ever | awareness and questionnaires | paren in risks had serual | interest of youth sssociated with iercourse from | and parents in the “Let's Tatk” | sexual activity 46.4% 10 40%. | abstinence Alaska, current before marriage message through recipient of newsletters and Federal Grant | -Education of advertising paren on how to -Nevada State | talk to their “More Health Division's | teenagers with adolescents: Abstinence ‘encouragement to waiting until Education abstain from marriage before Director sexual activity engaging in ‘until mariage sexual activity Eagle Valley Middle Schoo! | -Ongoing data Less adolescents input of student experiencing Carson Middle | questionnaires depression and/or School displaying “Complete no less suicidal behavior ‘than 150 related to sexual presentations activity “Train 14 new volunteer -tucreased speakers each umber of year speakers Continue to Help youth partner with local become aware of pastors and the prevalence clergy for and referrals to recruit ‘consequences of speakers STDs. -15-Pregnancy Counseling Center. In) A Cts Pregnancy Center ‘ject Name: Werth the Wit APPROACH. The following timeline lists each proposed activity, its justification, and factors which may influence the rate of its completion. For the purpose of maintaining integrity to the project, the following plan of action has been assigned dates of completion within a year of granting date. Every attempt will be made to meet and maintain the date-specific goals of the project. WTW used comments and suggestions received by youth, parents, volunteer speakers and youth workers in the past year when planning the following program activities. For the purposes of clarity, please note that “Worth The Wait” (WTW) is the program. name and the project for which funding is sought. The curriculum being utilized by 'WTW is entitled “Sexuality, Health and Relationship Education” (SHARE). WTW is a program of the Crisis Pregnancy Center (CPC) of Reno/Sparks. -16-eu Colig Cnn, DBA Cis Prepay Cer Projet Name Work Wat 2005-2006 Timeline Proposed Activity ‘Reason for taking proposed approach rather than | Factors that might Month by others accelerate or decelerate | which the work proposed orpossible barriers | activity would be Hire 3 WTW coordinators | See “Staff and Position Data” on page 28 for deals. | Completion date listed | October 2005 ‘The coordinators will each work with a community or | depends on notification people-group that has expressed interest in or need for | of grantawerd status and shstinence education, These communities ar, avalabity of qualified specifically, the rural community, the Native American | job candidates, community, and the Hispanic community, ‘The rate at which vacant ‘WIW positions are filled will influence all subsequent activities, All dates of completion asoume tat all WIW position are filled. A greater numberof filled positions will allow for a timely mte of activity completion, Hire | receptionist/data See “Sta and Position Data” on page 28 for details. | See Above October 2005 analysis manager, Fire | Administrative See “Staff end Position Data" on page 28 for details, | See Above. | October 2005 Assistant ‘Send 3 coordinators to Once trained, these condnators wil be qualified to | ‘Apri 2006 Kirkland, WA for taining in_| train volunteer speakers for Nevada commutes in the |Prune Cruseg Cee, ne. DBA Cis rene Cer jet Nan Work et Sexuality, Health And ‘SHARE curriculum for use in the WIW program, Relationship Education WIW isa volunteer-driven program, so tained (SHARE) Relationships 201 | personne! are essential in order to equip these Curriculum, Volunteers with all necessary information, ‘Send Program Director to | SHARE relationships 501 curriculum is intended for October 2005 Kirkland, Washington for | highschoo aged youth, Curent, WIW ony lies SHARE Relationships 50] | Relationships 201, which is used for middle school traning ged yout. By expanding to icdeReatonhins 501, WTW will be able to reach a greater number of youth wih age-spprorate materi Send Program Director to | “Let's Talk” also utilizes the SHARE curiculum and is November 2005 Anchorage, AK for an existing grantee ofthe Section $10 Federal | observation in the ‘Let's | Abstinence Education Gran. Observation and training Talk” Abstinence Education | from “Let's Talk” will supply WTW with ideas for Progam. how to best utilize funds game in the activites listed here, Purchase Advertising space | By advertising in these particular venues, more teens December 2005 ‘and time for the promotion | and parents will be reached with the abstinence of abstinent lifestyles among | message. These partial venues proved more Youth inthe following reasonable in cost and have a lange viewing community venues: movie theater | within the ages of 12-18. | preview ads, taxi cabs, Purchase Xerox Printer, Ink In-House printing has proven to be more cost-effective October 2005 | and Paper for mass and will allow more flexibility in distributing the parent | production of parent educational newsletter, | newsletter, =| Generate and distribute ‘According tothe Palo Alto Medical Foundation, Inthe eveat of | Quarterty; | parent educational newsletter | research shows that teens that have talked with their | unforesen obstacles | Begin through mail, community | parents about sex are more likely to postpone sex during printer purchase | December | agencies, churches, and the | (ttp!/pamforgheen/parentssex/sex.html) The parent | or newletter generation | 2005, Continue like, ‘newsletter will provide ideas and methods for how to ‘or prining distribution | every March, +18.‘Preraney Cousin Cnt, nc. DBA Criss Pregnancy Center Project Nee: Worth he Wait talk with their teens, provide a place for parents to | may bedelayed, June, Share helpful experiences with each other, and, September and ultimately, stengthen teen-parent communication, | December Print 2,000 custom-made | These professionally designed brochure providea | Brochues are being | December 005 ‘informational program concise and effective way to inform interested entities designed pro-bono by brochures of WIW and its different presentation options. Foran | Global Studios. Their example of this brochure in its rent form, see compleion date depends Appendix “B,” Please note thatthe brochures still in | on Global Studios’ the editing stages, svalability to work on this proj Take WTW to youth | By geting ens that interac largely wih the target December 1005 programs schol, churches | population adolescents aged 12-18) through and other community ‘informational brochures and personal introductions, a organizations. WTW will be | broader teen audience will be reached. marketed asa free {presentation Purchase a L-year supply of | The commitment cards are the key component ofthese October 2005 all materials included in packets, According to the SHARE curriculum, | youth information packets | Research shows that when students sign a pledge for distributed at each youth | abstinence, they have e greater chance of keeping that presentation, including | commitment, WTW commitment cards have been abstinence brochures, custom-designed to match its presentation and commitment cards, writing | message, utensil, bookmarks, candy and bags to contain said | Other supplemental information distributed reinforces materials. ‘and expounds upon material covered in presentations, such as expressing love without sexual expression, recogniing rea love, sks and nature of STD's, et, ‘The pencils included allow students to respond to the student questionnaire in non-school settings where ‘writing utensils are not avilable,5, as well as 2 edited versions “Curriculum Summaries” Section and Appendix “G” for details. ( t WIW isa volunteer-driven program, With an expected November Nevada | increase in requests for presentations asa result of 2005, expanded area of coverage, more volunteers will be May 2006, and ‘required to fulfill community needs. Speakers will be semi-annually trained at the CPC building location and the Rural thereafter coordinator will utilize public library meeting rooms as Additional ‘taining facilites as needed, so that volunteers in trainings will be ee added as needed, ad Tati ib maaan a a December speaker to present a portion ofthe SHARE curriculum 2005, Reno, | inorder to receive feedback from other speakers and June 2006 and coordinators, This provides an opportunity for skill semi-annually evelopment end refining te presentation, Aereatr ining | After training speakers in the Relationships $01 January 2005 tive | curriculum, WTW can begin to market and present the high school (10°12 grade) presentation. 00 nto bePrepay Caseig Cen, a. DBA iss Pep Cte Prete: Wah et ‘Youth Programs avenue of immediate contact between adolescents and round the abstinence message, In-class observation of ‘Necessary for ensuring that quality and integrity ofthe Ongoing, speakers by coordinators to | program is maintained, Year-round, monitor presentation quality Semi-monthly Calculation and Analysis of | See “Evaluation” Section below, Ongoing, ost presentaon youth | Yearsound 3 Analysis of WTW program | See “Evaluation” Section below, 6-month (March 2006) | year | (September I 2006) Program Director Travel to | Trip requited per grant instructions, Dates not yet Washington, D.C. for annual known, ‘grantees meeting in ‘Washington, DC for three days and two nights, By the end of September, 2006, all date-specifc activities above should be completed. WTW wil then be prepared to continue all ongoing, quarterly, semi-annual and annual activities, reaching as many youth and parents as possible,, and Format ‘inconvenience when working with venues not possessing this technology, Lapp computer and igi projector technology is idea for WIW's presentations, ait allows the speaker tobe “hands- fee” and mobile inthe classroom. The presenter is therefore more aocessible tothe goings-on of the youth. ‘Because the speaker isnot preoocupied with handing slides, pens, and projector, be or she may focus more attention on youth, Microsoft PowerPoint, the software to be utilized, also provides a technological venue that Keeps the interest of many youth who are accustomed to high-technology presentations, ‘The SHARE curiculum visual aides already exist in PowerPoint format, ‘Necessary for use in above-listed technology, Novermber 2005 inthe etPoint Al speakers must be comfortable with the new presentation technology in order for presentations to contain smooth transitions and be executed effectively Many volunteers may clready be familiar and comfortable using this technology thsi the case, their training may beless time-consuming than fr those who are ‘unfamiliar with PoweiPoint. December 2005 Atthe core of WTW, these presentations provide an | aa nePregnancy Comecing Contes OBA Criss Pregnancy Center Project Name: Woet he Wait EVALUATIO! ‘After the completion of each WTW presentation, questionnaires are distributed, completed by all attending, and collected. All incoming post-presentation ‘questionnaires are added up, and the totals are put into pie graphs for organized analysis, of each presentation’s effectiveness. Adolescent attitudes are also gauged by these graphs. From the outcomes, WTW can decipher areas in need of improvement as well as particularly effective areas within the program. Both weak and strong points will be shared with speakers at subsequent workshops, during which time all speakers, assistants and coordinators will collaborate to generate solutions for problem areas. Combined data from all compiled post-presentation graphs will allow WTW to objectively measure its progress in reaching the goals set forth in column 5 (“goals”) of the logic model at 6- month intervals. Please see Appendix “C” for an example of the 6% grade one day post- presentation questionnaires (noting that other presentations such as 7 and 8" grade one day have different questionnaires) and Appendix “D” for an example of the graphs produced from calculation of these questionnaires. In addition to youth post-presentation questionnaires, one speaker evaluation is supplied to the coordinating entity or leader at each presentation. This individual is asked to honestly rate the speaker’s clarity, rapport with students, and overall presentation. This individual is also supplied with a stamped envelope addressed to WTW’s Program Director, who reviews all speaker evaluations in order to monitor speaker quality. Any problems which may arise are addressed as needed with a preliminary conversation followed by any additional training and practice needed by the speaker in question. Please see Appendix “E” for an example of a speaker evaluation.Pregnancy Counseling Center, nx: 4 Crisis Prognancy Center 1 feetName: Worth the Wait Extent to which project has achieved its stated objectives. Because each portion of the post-presentation questionnaire has been designed to closely reflect WTW’s objectives, the extent to which the project’s objectives have been achieved is uncomplicated to measure. Several of the questions use a Leichert scale (e.g. Please rate the following: “I believe that sex and intimacy are the same thing.” (a) strongly agree, (b) agree, (c) not sure, (d) disagree, (e) strongly disagree). Another portion asks each student to honestly (and anonymously) relate his or her position on sexual abstinence. This portion’s output is a concrete number of students who are now committed to abstinence as well as a concrete number of students who do not plan to abstain. These numbers allow a calculation of the extent to which the project's stated objectives have been achieved. ‘This portion of the questionnaire also allows abstinent students to indicate whether they are abstinent as a result of attending a WTW presentation, or because they had previously committed to abstinence. This distinction allows WTW to clearly measure the extent to which the accomplishment of objectives can be attributed to the project. This question accomplishes the same thing that a pre-presentation questionnaire would. That is, a pre- presentation questionnaire can be measured against a post-presentation questionnaire for changes in attitude, and allows a program to reasonably state that any changes in attitude are a direct result of their presentations. However, WTW has, in the past, utilized this system of pre- and post- measuring, and found that the youth are unenthusiastic about the amount of paperwork. Using two separate questionnaires also took away from the time spent on the presentation. To resolve these issues, WTW discontinued use of the pre- questionnaire and modified the post-presentation questionnaire to successfully andPregnancy Counsting Center| DBA Crisis Pregnancy Center Project Name: Worth the Wait reasonably measure the attitude changes attributed to their presentations. Currently, post- presentation questionnaires show a change in attitude toward healthier sexual behavior and opinions. WTW also looks for a corresponding change in youth behavior supported by State health statistics. Procedures to be employed to determine whether the project is being conducted in a ‘manner consistent with the work plan presented. At 6-month and 1-year intervals, all activities completed to-date will be measured against the plan of action in a meeting between WTW coordinators, Program Director and Administrative Assistant. The purpose of these semi-annual meetings is to maintain accountability to the timeline and quality of work set forth in the Plan of Action. Impact of the Project’s Various Activities on the Project’s Effectiveness. WIW’s main activity is the Youth Presentations. These presentations are paramount to the effectiveness of the program, because they allow personal delivery of the abstinence ‘message to Northem Nevada’s youth. Moreover, the feedback received from these presentations and the resulting data thereof are received directly from the target audience and therefore provide the most authentic, measurable outcomes. By updating the presentations into a PowerPoint format and broadening WTW’s area of coverage with new staff and volunteers, Northern Nevada youth can be more effectively and extensively coached in healthy decision-making regarding sexual abstinence, goal- setting, and choices which may further those goals or hinder those goals (such as drug and aleohol use).Pregnancy Counscing Centr, lac; \ Crisis Pregnancy Center 1 petNane: Worth he Wait Advertising in venues frequented by teens will also reach those youth yet un-reached by the abstinence message, and provide support for those who have made a commitment to abstinence. Quarterly parent newsletters will equip parents with methods, ideas, and tools for talking with their teens about healthy life choices, particularly regarding sexual abstinence. According to the Palo Alto Medical Foundation, research shows that teens that have talked with their parents about sex are more likely to postpone sex (http://pamforg/teen/parents/sex/sex. html). By reaching the parent community, the teen community (ages 12-18) will be reached more effectively. RESULTS OR BENEFITS EXPECTED. Please see column 4 (“outcomes”) of logic model on page 14 . These outcomes are concrete and measurable. The current percentages and rates were taken from the Nevada Youth Risk Behavior Survey and the Nevada Sate Health Division Bureau of Family Health Services from the year 2005. ‘These numbers are updated every two years. In 2007, WTW will look for the decreased numbers set forth in column 4 of the logic model. The goals listed in column 5 of the logic model and the objectives set forth in the “Objectives” section (page 8) will also be assessed for progress made (Please see “Evaluation” section above, starting on page 22, for details). With the success of WTW’s goals and objectives, all of the considerations listed in section II “Problems Requiring a Solution” will be addressed in a positive way. WTW plans, to the greatest extent possible, to provide a solution to each of those problems. WTW believes that, with the right tools, information and support, youth are capable ofPregnancy Counseling Cente DBA Crisis Pregnancy Center 15, Project Name: Worth the Wait making positive life choices which will help them lead healthy emotional and physical ives. WTW is committed to providing this information and support to Northern Nevada youth. ‘SUPPORTING DOCUMENTATION. Testimonials. The following are testimonials regarding the WTW program from concemed interests other than the applicant. The following are taken from the “comments” section of student post-presentation questionnaires and speaker evaluations. “This was the perfect presentation for 6" grade. Almost every student said they leamed something and that it made them really start to think about their sexual limits. [The speaker] was great and the students could really relate to her. ‘Thanks so much!” -6® grade health teacher “Pm thrilled with this program! The acknowledgement of arousal and intimacy is so important! I felt the DISTINCTION made between intimacy and sex was done very effectively.” -8" grade health teacher. “Outstanding presentation! Talks in language and examples that middle- schoolers understand. Great flow.” ~7" grade health teacher “can’t say enough about the program! It beautifully supplements what I'm teaching.” Middle School health teacher “Pm thrilled to see a discussion of sexual progression.” -Religious educator of adolescents. “It was cool because I didn’t know what infatuation was until the presentation.” grade student, age 13 -21-Pregnancy Counseling Center, nc Criss Preguney Center {Fst Name: Worth the Wat * “thought if you were mature, like 18 years old, you could [have sex]- but now 1 think you should wait until you are married.” -8" grade student, 14 years old © “Seeing that presentation really made me think about sex and the good and bad things about it. I am definitely waiting ‘til I’m married to have sex.” -7" grade student, 12 years old. ‘+ “I felt very confident because someone came and knew what to say...Now I know the information I wanted to know.” ~6" grade student ‘+ “Itmade me feel like I’m not the only one who is going to wait to have sex until Letters of Support. In Appendix “A,” please find letters of support regarding, the WTW program from concerned interests such as; Eagle Valley Middle School, City of RenoYouth, Our lady of the Snows, State of Nevada Health Department, and Carson Middle school. GEOGRAPHIC LOCATION. WTW (Worth The Wait) is currently active in the Washoe and Carson Counties of Nevada. WTW will expand its coverage to include the Storey, Douglas, Lyon, Mineral, Churchill and Pershing Counties and the greater Truckee, California area. Although Truckee is located in a neighboring state, it is included in WTW’s area of desired coverage because of its close proximity (approximately 32 miles West of Reno, NV) to Washoe County, Nevada. For the purposes of this grant, all of the above are referred to collectively as “Northem Nevada.” ‘The following map shows an approximate coverage area enclosed within the black box.‘Project Name: Wort the Wait ‘Worth The Wat's Desired Area o Coverage e STAFF AND POSITION DATA. _ Ina six-month period (January 1, 2005 ~ June 1, 2005), WIW (Worth The Wait) has reached 776 youth in 2 Northern Nevada counties with the abstinence message through presentations and abstinence rallies. WIW was founded by the Reno/Sparks CPC in 1994 and has been active in abstinence education for 11 years. Because of WTW’s extensive previous experience in providing abstinence education among adolescents as defined by Section 510(b)(2) of the Social Security Act, WTW is prepared to expand their area of coverage to the areas identified previously (see “Geographic Location” on page 27). WTW is Northem Nevada's only abstinence-only education program. Listed below are WTW’s current staff and, in a separate chart, WTW’s total desired (proposed) staff. Please see Appendix “I” for a complete organizational chart of CPC and WTW. -29-Pregnancy Counseling Center, Inc| Crisis Pregnaney Center jet Name: Worth the Wait ‘Current WTW Staff Job Title | Job Description ‘Job filled by (individual's name) Program Hire and train volunteers and staff in | Mechele LaBrie. Director SHARE curriculum. Schedule WTW presentations. Maintain contact with | Please See Appendix “H” for and monitor performance of volunteer _| Biographical Sketch. speakers. Reporting and maintaining organized records for grant. WIW presentations as needed. Marketing | Develop marketing materials for ‘Amanda Dykes Coordinator _ | WTW. Compile contact information and reach possible interested entities _| Please See Appendix “H” for with WTW information. Process Biographical Sketch. incoming data from post-presentation questionnaires. Assist in volunteer trainings and presentation scheduling. Speak at scheduled WIW presentations. Assist with grant writing and reporting. Generate and distribute parent newsletter. Proposed WTW Staff Job Title | Job Description = ‘Job filled by (individual’s name)- Program ‘See Above “Mechele LaBrie. See Director ‘Appendix “H” for Biographical Sketch ‘Administrative | Develop marketing materials for WTW. Compile | Not yet filled Assistant contact information for Reno/Sparks Area and reach possible interested entities with WTW (Will replace | information. Assist Data Analysis Manager in Marketing | processing incoming data from post-presentation Coordinator | questionnaires. Assist in volunteer trainings and position) presentation scheduling: Speak at scheduled WTW presentations. Assist with grant writing and reporting. Generate and distribute parent newsletier. “Receptionist” | Receive and address/direct incoming calls and | Not yet filled Data Analysis | requests for presentations. This individual will Manager _| receive and direct phone calls and assist with J =30-Pregnancy Counseling Center| >BA Crisis Pregancy Center Prec Name: Wont the Wat processing data from post-presentation questionnaires. This individual will also be available to help assemble youth informational packets for presentations and provide help where needed to Program Director, WTW Coordinators, and Administrative Assistant. WIW | WTW coordinators will market, supervise and | Not yet filled Coordinators | organize WTW functions in 3 respective venues: Gtotal | Hispanic community, Native American positions) | community and Rural communities, This will allow for specialized cultural sensitivity, 3 Focus _ | connectedness, and more personal interaction ‘communities | with each group. This will also allow Program (respectively): | Director to focus personal efforts on the greater Reno/Sparks area. These 3 coordinators will also I. Hispanic. be available to speak at WTW presentations ae during school/work hours, when many volunteers aad are not available. [Communities PLAN FOR PROJECT CONTINUANCE BEYOND GRANT SUPPORT. = WTW is supported by its parent organization, CPC. CPC is primarily funded on an ongoing basis through local business and private donors. In addition to this, CPC hosts two major fundraising events each year for the generation of funds. The amount requested in this grant application would allow WTW to cover major expenses for the implementation of activities listed in the timeline that transcend the normal budget of CPC. These activities, each having a high purchasing and implementation cost and low subsequent operation cost, will be able to be maintained by non-grant CPC funds after initial implementation. al purchase of the laptop computer technology and newsletter For example, the i printing technology listed in the timeline are costly in nature, but once purchased can be used at litle additional cost for years. Personnel funded by grant money have been assigned salaries in amounts that can be maintained by CPC’s normal budget. By using ‘grant funds to initiate projects and activities that can be reasonably sustained by CPC’s -31-Pregnancy Counseling Center, In’ A Crisis Pregnancy Center | iest Name: Worth the Wait normal budget, WTW is ensuring that the target audience (youth ages 12-18) will continue to be reached beyond the grant support time period. This is critical, as WTW is the only provider of abstinence-only education in Northern Nevada as defined by Section 510 of Title V of the Social Security Act. WTW will also seek and apply for abstinence-education-related grants which may become available in the future. ORGANIZATIONAL PROFILES. The CPC of Reno, the parent organization of WTW, was founded in 1983 to aid women and families in crisis pregnancy situations. CPC, a 501C(3) non-profit organization, has always operated on a small budget, yet has offered support and met practical needs of men and women for more than 20 years. Please See Appendix ““F” for proof of non-profit status. Comprised of ten staff members, CPC has primarily functioned with trained volunteers. CPC, a United Way agency, efficiently operates on a budget of $255,000 a year. In 2004, the CPC was able to provide individuals with free services 1,546 times. CPC and WTW are housed in a 3500 square foot office building and are primarily funded through local business and private donors. An eight-member Board of Directors is made up of local business men and women who support the purpose of CPC and the mission of WIW. WTW is currently a sub-grant recipient of the NSHDS Title V Abstinence Education Program. This money originates from the federal grant. This grant is in the amount of $46,000 for a one-year period (October 2004-September 2005). This grant has been renewed for 1 additional year at a decreased amount yet to be announced. -32-Pregnancy Counseling Center, DBA Crisis Pregnancy Center Project Name: Worth the Wait ao oo os Letters of Support Example WTW Program Brochure Example Post-Presentation Questionnaires, Example Presentation Data Graph Example Speaker Evaluation Proof of Non-Profit Status SHARE Curricula outlines |. Biographical Sketches Organizational ProfilesSTATE OF NEVADA bo KENNY. GUINN ALEX HAARTZ.M Governor ‘Adninsnor MICHAEL J. WILLDEN BRADFORD LEE, MD. ‘Dect ‘Sie Health Ofc DEPARTMENT OF HUMAN RESOURCES HEALTH DIVISION $05 E, King Street, Room 201 Carson City, NV 89701-4797 ‘Telephone: (775) 684-4200 * Fax: (775) 684-4211 June 10, 2005 ACYF Operations Center C/O The Dixon Group, Inc., ATTN: Family and Youth Services Bureau Community-Based Abstinence Education Program Funding, 118 Q Street NE., Washington, DC 20002-2132 Dear Colleague: ‘The Nevada State Health Division supports the Crisis Pregnancy Center as it applies for abstinence education funding through the Community-Based Abstinence Education Grant from the Administration on Children and Families. ‘The prevention of teen pregnancies remains one of Nevada's priorities, Nevada’s adolescent birth rate for 15-19 year olds has remained high compared to other states, An effort such as Crisis Pregnancy Center's “Worth the Wait” program offers adolescents information from which healthy choices can be made. ‘The Nevada State Health Division has implemented abstinence education programming since 1998 as a part of efforts to reduce the teen pregnancy rate. Community based abstinence education programming is one tool that may assist in achieving that goal. Therefore, the Nevada State Health Division encourages organizations such as the Crisis Pregnancy Center to administer community based education such as “Worth the Wait” to address the needs of their community. Sincerely, ROE ‘Alex Haartz, MPH. Administrator Alc Al rs PPENDIX Poblic Health: Working fora Safer anel Healthier NevadsCUR lady Of the st.ows Office telephone 775-323-6894 1138 Wright Street - Reno, Nevada 89509 Fax telephone 775-323-6749 snows@intercomm.com February 10, 2005 To Whom It May Concern: The Crisis Pregnancy Center of Reno recently made a presentation to our junior high students on the lopic of abstinence. The title of the program was ‘Worth the Wait’ and we were very pleased. It engaged the students and held their attention, giving them new information on a topic which they felt they already knew so much about. : This curriculum used science and statistics to take the young teens beyond the fear of sexually transmitted diseases to understanding that they were more than biological specimens, and that the consequences of sexual activity outside of marriage include emotion consequences. There were four teachers and three parents in the room in addition to myself; not only we were pleased with the presentation but the feedback later from the students was what we were looking for. The survey at the end was also a useful educational tool. 1 look forward to offering it again next year and reaching a larger number of our junior high students. ri Anne Reinhart Director of Religious Education 775-329-6147 ~44- APPENDIX “ACarson City Middle School 1140 W. KING ST « P.O, BOX 603 « CARSON CITY NEVADA 89707 « (775) 2802500 « FAN 7S) 2872800 Crisis Pregnancy Center “Worth The Wait” 200 Brinkley Ave. Reno, NV 89509 Dear Coordinator, Twould like to request the services of Mechele LaBrie and the other speakers who work with the Crisis Pregnancy Center. Having had Mechele in my classroom, I can honestly say that her presentation and the message it sends is both worthwhile and invaluable. T teach a comprehensive sex education class for 6", 7" and 8" grade students. While we discuss puberty, anatomy, reproduction, and sexually transmitted diseases, I feel that the most important part of the curriculum is that of responsible decision making..which equates, at this age, to abstinence. ‘The Crisis Pregnancy Center offers a program that explores how goals, both short term and long term, can help students make healthy decisions. It also addresses how some decisions (such as getting involved in a sexual relationship at an carly age...) can greatly interfere with our students’ ability to achieve their goals. The way this information is presented is creative, thought provoking, and interesting. More importantly, it is heartfelt. The kids don't feel preached to: they feel valued and empowered by the message. My request is for Mechele or another speaker to address my 6" grade class every six weeks for a total of six visits (two classes each six weeks). T would also like to request a speaker for the two hour teenage parent presentation for my eighth grade class. This would occur twice during the school year...once in the Fall, once in the Spring. T appreciate the assistance of the staff and volunteers at the Crisis Pregnancy Center, This agency helps me take a curriculum I'm proud of and make it even better. Sincerely, ie yt ee Lisa Schuette Carson Middle School Health Teacher APPENDIX "A" -45- CARSON CITY SCHOOL DISTRICT * CARSON CITY. NEVADA4151 East Fifth Street Carson City, Nevada 89701 (775) 885-6570 Lagle Valley Middle School June 1, 2005 Dear Mechele and Amanda: On behalf of the students at Eagle Valley Middle school, 1 would like to thank you for speaking to the 6", 7", and 8 grade health classes throughout the 2004-2005 year. Your presentations were informative, entertaining, and impacted so many students. On the end ‘of course evaluations, students stated that they enjoyed the presentations and many say it ‘was one of their favorite things in the course. I definitely plan on continuing the program for the 6" and 8" grade rotations of my classes next year as I believe it will have a lasting impact on my students’ futures. Once again, thank you for your wonderful presentation. Your efforts help make our program more successful! Sincerely, . tw elo Amy Kelf Health Teacher APPENDIX "A" ~46- Carson City School District, Carson City, NevadaSebruary 18, 2005 ‘To whon it may concern’ ‘The City of Reno Youth Service department has been in-collaboration svith the Crisis Pregnancy Center for the past couple of months. We have sckeduled “Worth the Wait presentations a: four of our after schoo! teen Reno Enrichment Programs: Neil Rd. Recreation Center, O”Brien Middle School, Sibayan Recreation Center and Traner Middle School The Cirisi Pregnancy Center has professional speakers to reach out to teens. The Crisis Pregnancy Center works around our program hours and is very conporative and flexible. Cosi Pregnancy Center is a valuable resource of information for our teens in the program. There is a great need for the sexual health, awareness and education (S..A.8.E) program to the youth in our community. “Worth the Wait” has been a great success for our teen programs; it has presented more opportunities and choices in a teen’s fe “Worth the Wait” presentation is a program the city will contiue to implement at all our afier school teen programs. We look forward to more presentations and positive feedback fiom the teens, incerely, ne Heidi Lyon Recreation Coordinator City oF Rano, Parks and Recreation & Comraunity Services ~47- APPENDIX “AEagle Valley Middle Schoo! 4131 East 5" Street Carson City, NV 89410 February 15, 2005 To Whom It May Concern: The Crisis Pregnancy Center has come to my class to speak to my students on two occasions. 1 was thrilled with the presentation and the outcome both times. ‘The first presentation addressed my five eighth grade classes. Mrs. La Brie talked about levels of ‘sexual intimacy, sexual expression, abstinence, love vs. infatuation, and marriage. During our follow-up discussion the following day almost all students stated that the presentation made them think deeply about sexual expression and evaluate their personal limits. In fact, in the follow-up survey 55% of my students stated “After today’s program, I have changed my opinion about sex before marriage”. Mrs. La Brie empowered my students by letting their input and goals for the future drive the discussion and reinforce the major points of the presentation. My students indicated that they appreciated Mrs. La Brie sharing her story of being a teenage parent. They were able to relate to her life experiences. My hope was for students to make choices about OMNES PREGHANCY COUNSELING CTR. INC PRECMUNCY COUBSELIMG CTR. 1M 200 BRIMEBY AVE: REY, YY 89509 SUNMARY OP CHANCES AGE TOTALS BY QUARTER qe aporreo connecreo NET TAIABLE CONT FORREIT/ IT IALANCE ENDING TOTAL ——MON-TAY_—TAXABLE. TOTAL ——NON-TAL—TALABLE ADJUSTWENT “DUE “PENALTY DUE ONG Ak 31 22968.06 6.60 1969.06 12969,06 4.00 72968.06 0.0000 8000) 00 WH 33513.10 O00 3819.10 39519.10 00 3351.80.00 ooh 800.00 SEP 30 28438.57 Oe 28498.57 28408.57 O00 dst 000008 ak 00 DEC 31 3087.18 oe sine7.2e 30107.28 6.00 ane O.00 008 atk roras —115109.11 0.00) 1nst03.e1115109.01 CO FOR YER 1003 Total ovieg is for audit adjustaents only and does aot include prior balance, i¢ aay ZAPiANAT OW OF ADSUSTABNTS REPORTED anOvE ‘iepariaent ingut error EXPLANATION OF CHARGES REPORTED ABOVE Ui Thi RATE: 6.256% CaP TAL RATE: 6.630% OTe $0.00 CETL: $0.00 ruareli: ¥9 rum eaun ouuagula 77 PENALTY: 1/08 OF TATABLE WAGES FOR BACH MOWTH AFT OBLTAQUEAT sateeeyt: 1/4 Ur UbNidLaUT LORS FUR dati MiNi FaON veuLaWuENe unte ancuvuR oy sep sive 1s OF CONTRIBUTIONS FOR BACH NONTH DELIYQUENT FROM 1/1/2080 INTREST COMPUTED THRU 99/08/2005 {14 agree wien avait Canoings snows asore. ‘nee sumver 11 t-00 not agree wite auaie sanaungs anos visi suomit tarornation supporting ay position. sauune ral $_ gos” ive)ARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATION FOR CHILOREN AND FAMILIES NS 622521 FINANCIAL ASSISTANCE APPLICATION APPROVALINEGOTIATION SHEET 1. aTVPEOF OQ Coop Aart @ Dscretonary | 2 TYPE OF ACTION ae Onew O Supplement BIVPEOF Research © Demonstaton | © Revision © Supt and tn @ sevice other Okxtension O evn, and extn, O Training © competing Contn. © Supimt and Reva © Non-Competing Contn. © Closeout 3. BUDGET PERIOD 4, TOTAL PROJECT PERIOD FROM _09/3072006 THROUGH _03/2872007__|_FROM 09/3072005 THROUGH 0072972008 NAME OF APPLICANTIORANTEE ‘© APPLIGATION/GRANT NUMBER] 7. CAN Pregnancy Counseling Center DBA Criss Preg Cent gnancy ¢ 90aeo} 111702 ‘Awarded may be prepared from the information included therein, bY [| The application identified above has been approved as submited and the Notice of Financial assistance [| The application identified above has been revised based on negotiation between Phys N. Henderson Mechle LaBrie (Name of Negotiator) (Name of ApplicanGrantee Staff) 9. COMPLETE AS APPROPRIATE : (GRANT PROGRAM FUNCTION OR ACTIVITY : ‘BUDGET CATEGORIES Rastd Amt ‘REV-1 REV-2 ‘REV-3 ‘Apprvd Amt Personne! $117, ‘$111,169 1 [ sa.t6 Panota an sre a ane Finge Benefts 86.874 seer] - $26.7 Finge beef amount seed 8368 $2607 Tavel 13.864 7.024 7.02 Teva aout 13.6 sr024 : 7024 Exvioment ais sd __ ad | Eupmetamunt ~ 4 ‘ Sipoes Pre arra arr | Supplies amount a $33.6: $7.81 _ s778id | ontacat : se120d 9 sa. [Contractual amount sat $13.2 _ $13.2 Facities/Contruction _ Facity Purchase aout = = x Mejor Renovation amount - = - sd Construction amount _ - Cher sizeaed sez tsard Cte anecnt | sia. 125274 — sas Direct Costs. $371,3% $71,354 - $371,351 Indirect Costs E ~ | ota indret oss [inking Contotions # | _InkKind amount _ C =| Toa Approves Bodget ered sari ‘Bi3s Gace amo hoval FEDERAL APPROVED BUDGET saris 37135 : “sis Page ot Fu Dae 087142008 es)NS 622521 DEPARTMENT OF HEALTH AND HUMAN SERVICES. ‘ADMINISTRATION FOR CHILDREN AND FAMILIES FINANCIAL ASSISTANCE APPLICATION APPROVALINEGOTIATION SHEET egierrsceO conan nessa] eirieeoe enon ane re ss 8 hetaen Gsm wean emer 0 pam . TEES’ Qasr —Ooenestaon |S Eteate nena @ Service O Other © Competing Contn. © Supimt. and Reva. O Training @ Non-Competing Contn, (©) Closeout iucocer aa pourra From 10% Twnowon cozszoer | meow oooozen Tamovos! — onziaine Than SAPPORO

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