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Alameda County Transportation Improvement Authority <br />Special Transportation for Seniors and People with Disabilities <br />Do you intend to apply for 5310 funds in the next fiscal year? ^ Yes Q No. <br />The following questions are applicable if you intend to apply for minimum service level gap <br />grant funding for the next fiscal year. <br />We are applying for minimum service level gap grant funding for this nett fiscal year: <br />^Yes ~ No <br />If "yes", please complete the table below. <br />Minimum Service Level (MSL) Please describe how your Program <br /> program ezceeds, meets or falls Requesting <br /> below each minimum service Minimum <br /> level Service Level <br /> Gap funds to <br /> close this <br /> a ? <br />~ WHO PROGRAM SERVES Yes <br />• People 18 and above with <br />disabilities that are unable to use ~ <br />fixed route services. I <br />• Seniors 80 and above without proof ; ~ <br />of disability I <br />i j <br /> <br /> <br />YOUR PROGRAMEXCEEDS THIS I <br /> <br />~ <br />; <br />~ <br />~ ' <br />1 <br />~ MSL IF IS SERVES: <br />• Minors with disabilities ~ ~ <br />• Seniors under 80 without proof of <br />disability. <br />....................__................_.__............._._.__.....................__._....................._._......................_.~ , <br />....................._.........................._.........1 <br />Page 19 of 23 <br />C:\Documents and Settings\pdeatonU.ocal Settings\Temporary Internet Files\OLK3\Annual Program Application Cover FY0708 March 31 <br />2008.doc <br />