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10/28/94 10:11 NW YOUTH & FAMILY SERVICES a 484 4538 <br />MINNESOTA <br />BOARD OF GOVERNMENT <br />INNOVATION AND COOPERATION • <br />PRE- APPLICATION <br />COVER PAGE <br />L Applicant Name(s) List all proposed applicants. <br />- Northwest Youth & Family Services <br />- Cities of: Shoreview, Roseville, Little Canada, Falcon Heights, Lauderdale, <br />Arden Hills, North Oaks <br />• <br />2. Contact Person This person should be able to respond to questions regarding the pre - application. <br />Names Kay AndreWn Address: xM 01d' Highway 8, 0101 • . <br />Tido: • Executive Director New Brighton MN 55112 <br />� �� Northwest Youth & Family Services • ' <br />TelephonaNumber. ,(612) 636 -5448 Paxmonber (612) 636 -1584 <br />3. Grant Program Idesttijy the grantcdtegory far which you are submitting this proposal. <br />D Service Budget Management Model grant ($50,000 maximum) <br />; Cooperation Planning grant ($50,000•maximmm) <br />+: Service Sharing grant ($100,000 maximum) <br />4. Estimated Costs <br />Total estimated cost of the $ 100.000 <br />proposal <br />Estimated request $ 100,000 <br />grant <br />This pre - application is submitted to the Board of Government Innovation and Cooperation pursuant to <br />M.S. 465398, 465399, or 465.801. To the best of my knowledge, the information contained in this <br />proposal is accurate and complete. <br />y Andrews, Executive Director 08/23/94 <br />(TWO <br />(Dne) <br />('The cover page must be signed by the senior elected qr administrative official of one applicant agency.) <br />(SEE OTMERSIDE) <br />Page 33 <br />