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County of Hawai`i Nonprofit Grant Application FY2019-20 <br /> Agency Name: After-School All-Stars Hawaii <br /> Program Name: After-School at Kau High & Pahala Elementary <br /> Agency Director: Kimi Takazawa, CEP Phone No.: (808) 734 — 1314 <br /> Contact Person: Same Phone No.: ( ) — <br /> Mailing Address: Address: 4747 Kilauea Avenue, Suite 210 <br /> Address: <br /> City,ST,Zip Honolulu, HI 96816 <br /> Facility Address: Address: Program operates at Kau High&Pahala Elementary <br /> Address: <br /> City,ST,Zip <br /> Email Address: ktakazawa@asashawaii.org Fax No.: (808 ) 356 — 0232 <br /> Accountant/CPA: Lester Hee Phone No.: (808 ) 532 — 7323 <br /> Firm (if applicable): Hee&Ching CPAs LLC <br /> Mailing Address: Address: 201 Merchant Street, Suite 1830 <br /> Address: <br /> City,ST,Zip Honolulu, HI 96813 <br /> YOU ARE RESPONSIBLE TO KEEP THE ABOVE INFORMATION CURRENT AND TO <br /> PROMPTLY NOTIFY THE FINANCE DEPARTMENT AND COUNCIL OF ANY CHANGES <br /> Amount of Request for County Nonprofit Grant Program Funds: $8,000 <br /> Geographical Areas To Be Served: (One or more can be checked) <br /> n Puna ❑ Hamakua ❑ North Kona <br /> n South Hilo ❑ North Kohala ❑ South Kona <br /> ❑ North Hilo ❑South Kohala 0 Ka'u <br /> Services or Activities To Be Provided: (One or more can be checked) <br /> ❑✓ Educational concerns n Youth n Victims of Crimes <br /> ❑✓ Culture and the arts ❑Aged n Victims of Health or Social Crises <br /> [' Needs of the poor ❑ Physical/Emotional Disabilities <br /> [' Public Health and Welfare of the People and the Environment <br /> EXHIBIT A <br /> NONPROFIT GRANT APPLICATION FY 2019-2020 Page 1 of 8 <br />