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Page Two <br />1. Agency name: <br />Community Emergency Assistance Program, Inc. (CEAP) <br />1290 89th Avenue NE <br />Blaine, MN 55434 <br />783-4930 <br />Years in existence: 24 (8 in Anoka County) <br />Business address: <br />7231 Brooklyn Boulevard <br />Brooklyn Center, MN 55429 <br />Program director: Phone: <br />Victoria Peery, Resource Development 566-9600 <br />2. Program title: <br />Self -Sufficiency <br />3. Legal status: <br />a. 501 (c) 3 nonprofit - see enclosed verification form <br />b. See list of Board of Directors <br />4. a. CDBG Budget request: $1,000, FY1995 <br />b. Percent of total budget to be made up of CDBG funds: <br />Less than one percent. <br />c. Other funding sources: See budget and major donor list. <br />d. Other Anoka County cities to whom CEAP is requesting <br />funding and amounts: <br />Blaine $5,000 Approved <br />Coon Rapids $6,250 Approved <br />Andover $3,020 Approved <br />Fridley $3,000 Approved <br />Ramsey $2,000 Approved <br />Spring Lake Park $1,000 Approved <br />Ham Lake $1,000 Approved <br />Anoka $2,500 Approved <br />e. Cash match or in-kind services provided by agency: <br />CEAP provides the administrative support, <br />emergency food, and shelter -related assistance. <br />