Box 7, Folder 18, Document 11

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Title

Box 7, Folder 18, Document 11

Text Item Type Metadata

Text

OFFICE OF ECONOMIC OPPORTUNITY

VISTA PROJECT PROPOSAL

* Approval expires Dec

ember 31, 1966







(FOR VISTA OFFICE USE ONLY) (3-16)



SECTION I

SPONSOR INFORMATION



Ta. NAME OF SPONSOR OR OTHER PARTICIPATING AGENCY

i i i , Oth ici-
Community Relations Commission: [7] piting agency

[12-67 lb. PROPOSAL MADE 43 2. NO. AND STREET

BY
1 [ spon sor



| Card No. 42 | 12-35
68 Mitchell St., S. W.
Room 1205 City Hall













3. City OR TOWN 4. COUNTY | g9.51|5. STATE 6. ZIP §2-56|7- CONG2ES- | 57, 53/8. TELEPHONE (Area code and number)
ee sa CODE [s2-86 SIONAL Fog a7 58 i
Atlanta Fulton Ga. 30303 4th & | 404 [522-4463
5th ~ Ext. 433,434
9. . THIS SECTION TO BE COMPLETED ONLY BY PARTICIPATING OR COOPERATING AGCNCIES



A. NAME OF SPONSOR WITH WHICH THE AGENCY IS PARTICIPATING

OR COOPERATION (Check)

1 OC Co-sponsor jointly and
equally responsible for
conduct of project and
supervision and “et
of volunteers



B. RELATIONSHIP TO SPONSOR AND EXTENT OF PARTICIPATION

2 CO Will pro- 3 0

vide general
tupervision
of the
project

[so

Will undertake con-
duct of project and
supervision and
suppore of volun-
teers on default of
Primary sponsor



10, OFFICIAL REPRESENTING THE SPONSOR OR PARTICIPATING

| Cord No. 43 | 12-346



11, NUM3ER AND STREET (If different from Item 2)



















AGENCY
a, Name:
b. Title:
12. CiTY, TOWh, OR COUNTY 13. STATE 14, ZIP CODE 15. TELEPHONE (Area code and number)
:
;
16. TYPE OF PROPOSAL (Check) [a7] "7. RE OF PROIECT (Check) [38-39 18. Jaocaa
NO. OF VOLUN.
1 es) Initial proposal 1 CT Rural community development 30 oO Trusy Terr'y TEERS RE-
2 oO Amendment or extension 2 oO Indians—on reservation 31 -] Urban communiry OUESTED
oe appa 3 [[) Indians—off reservation 32 [FJ Menaally il 2
3 [1] Other specif) 4D Migrancs 33 [[] Job Corps—urban
: 5 C) Job corps—conservation 34 C] Justice
6 CO Rural—Appalachian 35 oO Menully retarded
7 fa] Other rural poor 36 oO Other urban poor
19. SPONSOR ORGANIZATION
A. PUBLIC AGENCY (Check) B. NON-GOVT. NON NON-PROFIT ORG.| 43] C. TAX STATUS [44 0. DATE OR-- [45-47
(Check) COMPLETE TEMS C AND 0, GANIZA.
1 E] City 5 C) Tribal Council 6 C] Incorporated 1 ey Ved eiempt-dare of peste
Z oO County CT Other (Specify) T C] Unincorporated Paling (Month—Year)
j 5 este 2 C] Non Tax Exempt | Lis e-nn yee eeeeeee
3) Non Tax Exempr-I®S | Jan, } i (1967





ruling applied for



20. PRINCIPAL PROGRAM OF SPONSOR
At Cc Community development

2 CO Job training

3 ([] Seif help programs

4 LC) Education

5 [a Health programs

6 [_] Mental healch

7 i Child care

8 [] Recreation Community Relations

10 Cc] Citizenship

11 (-] Nyc
12 [1] Job Corps

Mangower,
3 O dev: and training
14 F] Other fSpeifi)

9 C) Cooperatives [43-49

OTHER PROGRAM SUPPORT

B. SRIEFLY OESCRISE THE PURPOSE AND FUNCTION OF THE SPONSO2 AND ITS PAST AND
PRESENT ACTIVITIES TO COMBAT P2ZO3LEMS OF POVERTY.

Improve conmunity relations;
opportunity for all to develop fullest
potential; promote mutual respect,

tolerance, etc.

insure





ACCEPTANCE OF CONDITIONS

This proposal wich all forms, exhibits and attachments hereto, is submicted for consideration as a VISTA project.
representative oi the sponsor, that a project developed as a result of chis proposal is subject co the
‘Guidelines for Sponsors.’

and agreed by the undersigned authorized ¢
conditions sec forth in the VISTA manual, °

It is understood



¥. TYPED NAME AND TITLE OF SPONSOR

2. SIGNATURE



3. DATE





WISTA Form 420 DEC 65

Pg. 1 of 6

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