Hermanowski Family Foundation Initial Request Form

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Organization Name: Capernaum Ministries, Inc
Legal Name (if Different):
Also Known As: Capernaum Inn
Mailing Address: 3500 Canal Rd, Lake Wales
State: Fl
Postal Code: 33898
Main Phone: 863-439-1080
Main Fax: 863-439-7056
Organization Website: www.capernauminn.com
Employer ID Number: 593011848
Organization Tax Status: emempt

Proposal Information

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Today’s Date: 11/10/2011
Requested Amount: $10,000

Project Title: Save our Youth
Project Description:

Capernaum has partnered with the local schools, Justice System and churches to reach troubled youth. We have speakers go into the schools and motivate students to get out of gangs and drug issues. We then have mentors reach out to the youth that want help.

Total Project Budget: $10,000

Other Funding
Sources For The Project (Committed & Potential): none as of now

Project Duration: 2011-2012 school year
Geographical Area Served: Polk County , Fl
Age Group To Be Served: 13-21

Contact Information

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Contact Prefix (Mr,Mrs etc.): Mr
Contact First Name: Gary
Contact Last Name: Fish
Contact Title: Director of Ministry Outreach
Contact Phone: 863-837-0285
Contact Email: capernaum.fish@gmail.com