OCFS-5001 – County of Saratoga, New York

NEW YORK STATE
OFFICE OF CHILDREN AND FAMILY SERVICES
INDIVIDUAL PROGRAM APPLICATION
Program Information
Please follow the Agency Summary Instructions

Program Title

Program Year

FUNDING INFORMATION

Funding Category
Youth Development Funding RHYA-Part I RHYA-Part II Safe Harbour Other

Please Specify

County

FUND AMOUNTS

Total Program Amount

PERIOD OF ACTUAL PROGRAM OPERATION

From

AGENCY INFORMATION

This Agency is
Private, Not for Profit Public Religious Corporations

Federal ID #

Charities Reg. #

Agency Website

Implementing Agency

Mailing Address

Address Line 2

City

State

Zip Code

CONTACT PERSON FOR AGENCY

Last Name

First Name

Title

Phone Number

Extension

Fax Number

E-Mail

EXECUTIVE DIRECTOR FOR AGENCY