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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
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