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Attachment A (Cover Page) <br />PROPOSER APPLICATION <br />Agency Legal Name City of Santa Ana <br />Agency DBA Santa Ana WORK Center <br />Program Name STEM Career Program <br />Agency Address 1000 E. Santa Ana Boulevard, Suite 200 Santa Ana, CA 92701 <br />Contact Person & Title Carlos De la Riva- Economic Development Specialist III <br />Email CDelariva@santa-ana.org <br />Telephone # (714) 565-2629 <br />Fax # (714) 565-2602 <br />Federal ID Number 95-6000785 <br />AGENCYSTATUS <br />Public Non-Profit Corporation Private Non-Profit <br />Private for Profit Government X Other Years in Operation? 30 <br />PRIMARY FUNDING SOURCES <br />Funding Source WIA-Youth WIA-Adult <br />Amount 11.4 million I $651,978 <br />HOURS OF OPERATION AND DAYS <br />Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday <br />Hours 7:00am- <br />5:30pm 7:00am- <br />5:30pm 7:00am- <br />5:30pm 7:00am- <br />5:30pm 8:00am- <br />4:00pm Closed Closed <br />MY ORGANIZATION WILL OFFER THE FOLLOWING WIA ELEMENTS FOR YOUTH! <br />Tutoring, study skills, training, and instruction, leading to completion of secondary school, including dropout <br />prevention strategies <br />Alternative secondary school services, as appropriate <br />Summer employment opportunities that are directly linked to academic and occupational learning <br />Paid and unpaid work experience, including internships and job shadowing X <br />Occupational skill training, as appropriate, or paid OJT X <br />Leadership development opportunities, which may include community service and peer centered activities <br />encouraging responsibilities and other positive social behaviors during non-school hours x <br />Supportive Services x <br />Adult Mentoring for the period of participation and a subsequent period, not less than 12 months x <br />Follow-up services for minimum of 12 months after the completion of participation x <br />Comprehensive guidance and counseling, may include drug/alcohol abuse counseling X <br />TARGET POPULATION <br />Older Youth ? Younger Youth ? Out-of-School ? In-School ? <br /># of Youth to be Served in 2012/2013 20 Total WIA Funds Requested $160,000 <br />In compliance with the RFP noted above, and subject to the conditions thereof, the undersigned offers to furnish <br />the services stipulated and certifies he has read, understands, and agrees to all terms, conditions, and <br />requirements of this RFP and is authorized to contract on behalf of the agency named above. <br />Economic <br />Signature '`{t . ?' # ? Title Development Manager Date <br />Exhibit A