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Aloha Independent Living Hawaii- Atency Name <br />Independent Living Services- Program Name <br />Agency Director: <br />497 -2350 <br />Contact Person: <br />497 -2350 <br />Mailing Address: <br />Facility /Site Address: <br />Fax No.: <br />Email Address: <br />Roxanne Bolden <br />Roxanne Bolden <br />P.O. Box 283 <br />Purl City, Hawaii 96782 <br />94-909 Kau'olu Place #211 <br />Waipahu, Hawaii 96797 <br />1- 800 -385 -2454 <br />nubolden @alohailhawaii.org <br />Phone No.: 808- <br />Phone No.: 808- <br />Name of Accountant/CPA (include name of firm if applicable): <br />Newly incorporated, No CPA, only Book keeper <br />Phone No.: <br />Mailing Address: <br />Amount of Request for Cournty Funds: $10,000 <br />Prior Year(s) Funding: <br />08 -09 09 -10 10 -11 <br />$0.00 $0.00 $0.00 <br />Agency Mission Statement <br />To provide independent living programs and services to persons with disabilities <br />to assist them in living independently in the community. <br />NONPROFIT GRANT APPLICATION <br />FISCAL YEAR 2011 -12 <br />Page 1 <br />