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HomeMy WebLinkAbout8.1 Teen Esteem Attach 17 CITY OF DUBLIN COMMUNITY GROUP/ORGANIZATIONAL FUNDING REQUEST ApPLICATION PACKET Fiscal Year 2008-2009 Section 2: Application for Community Group/Organizational Funding SECTION 2 Page 1 of21 A-TTAe.Hm ENT 17 CITY OF DUBLIN Fiscal Year 2008-2009 COMMUNITY GROUP/ORGANIZATION ApPLICATION FOR FUNDS COVER PAGE AGENCY NAME: . TEEN ESTEEM PROPOSED PROJECT/PROGRAM NAME EQUIPPING FAMIUES - TEEN ESTEEM FUNDING AMOUNT REQUESTED: $20,542.55 SECTION 2 Page 2 of21 CITY OF DUBLIN Fiscal Year 2008-2009 ApPLICATION FOR FUNDS 1. Please select one expense category: 0 Capital X Operating 2. Applicant Information: Organization! Agency Name Teen Esteem Mailing Address P.O.Box 966, Danville 94526 Street Address City State Zip Linda Turnbull Executive Director/Chairperson 925-743-0438 Work Phone linda@teenesteem.com Email Tom Mason Board President (if applicable) 925-785-8825 Work Phone tr_mason@msn.com Email Please list the Primary Project Contact Person who would be able to answer questions about this application and project/program during the funding period. Linda Turnbull Director Contact Person for Project/Program Job Title 925-743-0438 linda@teenesteem.com Work Phone Email Fax Federal Tax Identification No. (required) 20-1598494 SECTION 2 Page 3 of21 City of Dublin Business License No. (required) Teen Esteem has a home office in Danville, therefore we do not have a Dublin Business license. City of Dublin Fiscal Year 2008-2009 Application for Funds 3. Proposed ProjectlProgram Information (Do not describe Organization.) Amount of Funds Requested $ (Maximum $25,000 per project.) $20,542.00 Proposed Project/Program Name Equipping Families - Teen Esteem Proposed Project/Program Date(s): Start 7 / 1 /2008 mo. day yr. and End 6 / 30 / 2009 mo. day yr. Please note: City Council Grant Funds are distributed on a reimbursement basis. If your Agency needs a 100% disbursement at the beginning of the Fiscal Year, please indicate this below and please provide justification for this need. X Agency is requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, please 'provide justification in the blank space below. o Agency is not requesting 100% disbursement at the beginning ofthe Fiscal Year. If selecting this option, please provide the frequency that reimbursements will be submitted to the City in the blank space below; e.g., montWy, quarterly, at project completion, etc. Due to the nature of preparing training material, training volunteer speakers, having parent education events at various times through out the year it would be beneficial to receive the funding in July. We have very limited staff that take care of the necessary arrangements for these steps to happen. We work over the summer and into the fall to prepare for the upcoming school year. SECTION 2 Page 4 of21 City of Dublin Fiscal Year 2008-2009 a. Application for Funds How would the requested funds be used? · Describe, in detail, the PROPOSED PROJECTIPROGRAM (not the Agency). · Bulleted text is acceptable. · Identify if the proposed project/program is a new service, or extension of an existing one. An additional page may be added, if needed. . Funding made available through this grant would allow Teen Esteem to continue presentations in the Dublin School District and to reach a larger audience with our message. We would provide education to students, parents. and the community on topics related to peer pressure, media influences, drugs, alcohol, sex, depression, eating disorders, cutting and the Internet. Presentations for students would be provided to middle school and high school students in a dassroom setting and through school assemblies. We would also provide presentations to youth programs as well as youth conferences. Presentations for parents and the community would take place through the school district as well as community programs and possibly local businesses. Events for parents and the community would be presented by professional educators, doctors and counselors and could cover the following topics: . The Media-TV, Movies, Music, The Internet, My Space, Face Book, U-tube . Self-image, Eating disorders and Cutting . Preparing for the Teen Years (provided to parents of children k-S) . Understanding Daughters · Understanding Sons . Parenting . Sex, Drugs and Alcohol . Depression/Suidde . Blended families- How to Make it Work The program would indude all training and the implementation costs associated with these activities. SECTION 2 Page 5 of21 b. How would the PROPOSEDPROJECTIPROGRAM address an unmet community need and improve the quality of life for Dublin residents. Why is this project/program needed? (Additional page may be added, ifneeded): c. The goal of Teen Esteem is to equip, educate and empower teens, parents, educators and the community on issues related to teens and adolescent health while addressing the importance of self-respect and respect for others. With the influences of the media, induding the Internet as well as the age of cell phones, children are exposed to infonnation they are not mature enough to process. For some, this is leading to curiosity and experimentation starting as early as grade school. The use of alcohol and drugs many times lead to sexual behavior that otherwise would not have taken place. Casual sex and oral sex are becoming just a past time for some and "binge drinking" is on the rise. These are many of the challenges our youth face today and can be difficult for parents to understand and know how to address. Teen Esteem consists of professional educators, counselors, doctors and individuals whom work with youth in the community and can identify the types of challenges many of teens face. during their adolescent years. Through student evaluations after a Teen Esteem presentation, we are able to identity and better understand the types of pressures and. choices many students are making, especially in the area of high risk behavior. At the end of every school year, a group from Teen Esteem meets to discuss the changes we feel are necessary to better meet the needs of families in the community. Our goal is to educate, equip and empower students to make the best choices possible during middle school and high school. Teen Esteem equips them to make choices that they will benefit from not only today, but for a lifetime. We want to help equip them to achieve their goals and dreams. For parents, Teen Esteem would provide educational events. with professional panel members addressing the topics listed above for parents of K-12 students. Our goal would be to help educate and equip parents to better understand the types of pressures youth face today and the types of risky behaviors they are engaging in. We would also provide infonnational events for parents with grade school children to help equip and prepare them for the years to come. We would provide infonnation, resources and encouragement that will assist during the parenting years. For middle school students, our goal is to prepare them for high school, discuss the types of pressures they will be faced with and empower them to make good choices. Our presentation is designed to instill the importance of believing in themselves and respecting not only themselves, but others. We will also address topics related to the Internet and My Space. For high school students, we address the types of pressures they are faced with everyday, the various types of high risk behavior some are engaging in and the potential dangers of those behaviors. SECTION 2 Page 6 of21 The program is designed to get students to think about the types of choices they may be making and openly discuss the risks associated with them. Through the discussion, teens can see how they are ultimately the ones that will benef'd: frOm making healthy choices. They are also provided with tools to help them avoid pressure and to understand that they have value and should set an expectation and standard on how others treat them. We talk about the emotional maturity of a high school student and discuss what they feel they are realistically capable of handling during their high school years. Our goal is to help them understand not only the dangers related to risky behavior but to really think through the pros and cons. We have the ability to relate to students on their level through our trained volunteer Teen Esteem speakers who are young and energetic. They create an environment where the students feel free to have open discussions. Our speakers challenge them to think about the types of choices they may be making and the impact it could have on them not only today but in their future. Through our insight, experience, presentations and resources, Teen Esteem can provide invaluable information and tools to help. families be better equipped and empowered during the challenging adolescent years. Healthier families lead to a healthier community. The attached letters support the need for Teen Esteem d. What documentation!datalrecords support the need for this PROPOSED PROJECTIPROGRAM? Please identify your data sources. (Additional page may be added, if needed.) . People who begin drinking before the age of 15 are four times more likely to develop alcohol dependence than those who wait until 21 (\'0WW;-':\'-':C\~(~\\-5' eon-,,) . Marijuana that teens use today has more than twice the concentration of THe, the chemical that affect the brain than the marijuana of 20 years ago (\,N'iNw.'th~\Kl . c. ) -->' O(r-.. . The use of alcohol or drugs many times leads to sexual activity amongst teens . America's newly defined at-risk group is preteens and teens from affluent, well-educated families. They experience the highest rate of depression, SECTION 2 Page 7 of21 substance abuse, anxiety disorders and unhappiness of any group of children in this country. (Advances inChild Development, Luther 5.5. &. C. Sexton> The comments and feedback we receive from the teachers, parents and students who hear Teen Esteem support that not only is our message important, but provides the information and dialogue that many young people need as they navigate through the pressures they face during their middle and high school years. What teachers are saying about Teen Esteem: "Teenagers today must face the reality of making difficult choices in areas such as drugs, alcohol and sexual behavior. Teen Esteem challenges many students to rethink some of their choices and the long term impact of their choices. Teen Esteem is one excellent resource for my Life Skills students. The students hear from their teacher on a regular basis and TE brings a new element into the room. It brings new voices, stories and discussion points. " ''In today's world with all the increased pressure our kids experience as teenagers, they need as much help as possible in learning how to make good choices. Our kids need to be able to talk about these issues and learn ways to make healthy choices. Teen Esteem encourages our kids to make right choices in their lives as it relates to drugs, alcohol and relationships. " What students are saying about Teen Esteem: "The speakers seemed to understand teenagers a lot more than other speaker's. They did a good job talking about stuff that is tough to talk about with parents and friends. " "After the presentation I felt empowered knowing that I deserve more than just a hook-up. " "I liked the presentation a lot. The speakers weren't just presenting, they were talking to us like friends. " "It made me think I realized that I need to start thinking about consequences before I act. " "I felt more empowered after I left. The speakers made an incredibly good point about not settling for less. " "I am very thanliful for the speakers talking about date rape because it is a big issue. Even though they weren't actually speaking to me it felt like they were. Thank you, you helped me through a tough time. " SECTION 2 Page 8 of21 What parents are saying about Teen Esteem: "Wonderful presentation. Helpful infonnation like knowing the statistics, hearing ''real'' stories and then giving us some tools to work with" "The information was clear and concise. I smugly thought I was approaching the subjects of family. Self- esteem, sex, goals etc. in a positive direction, but I am panicking that I'm not However, I have hope that today is a new day. Thanks for the wake up call" "Wonderful facts and points to discuss with our children Thanks for presenting ideas and ways to communicate information about sex to children and build stronger relationships. " "Vel)' helpful to know what kids are being exposed to today and what a lot of kids are doing. We will not learn this from our kids. " 'Tn today's world, with all the increased pressures our kids experience as teenagers, they need as much help as possible in learning how to make good choices. Teen Esteem encouraged kids to make right choices in their lives as it relates to drugs, alcohol and relationships. Our kids need to be able to talk through these issues and learn ways to make healthy choices. " SECTION 2 Page 9 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds d. Specify the PROPOSED PROJECT/PROGRAM population to be served. Middle School Students High School students Parents of K-12 students e. Projects/programs must be evaluated to determine if they are being carried out efficiently and if project/program goals are being met. Please describe how you plan to monitor your project/program's success and impact. · An additional page may be added, if needed. Every student who hears a Teen Esteem presentation will fill out; an anonymous evaluation giving us feedback about the presentation. Teachers will fill out an evaluation indicating if and how they felt their students benefited from the presentation. Parents will fill out an evaluation at the end of each parent education event with feedback on whether the information provided was valuable, what they liked and disliked about the presentation and what other topics they would like to see addressed. At the end of the school year we will compile report from the feedback we receive. SECTION 2 Page 10 of21 f. Specify numbers of clients served by agency, then by PROPOSED PROJECTIPROGRAM: SECTION 2 Page 11 of21 12,000 3500 3500 3500 City of Dublin Fiscal Year 2008-2009 Application for Funds 5. Financial Information - Operating Budget a. Expense Budget FY 2008-2009 THIs PROJECT/ EXPENSE BUDGET ORGANIZATION PROGRAM GRANT REQUEST Personnel Costs Employee Salaries & Benefits $80,459.00 $17,352.00 $17,352.00 Non-Personnel Costs Services & Supplies $$35,738.00 $3,190.00 $3,190.00 Capital Costs Other (please specify) Other (please specify) TOTAL $116,197.00 $20,542.00 $20,542.00 Further Comments/Explanations (if necessary): Our program is very labor intensive. It is the labor that provides the delivery of our message to families in the community through our volunteer speakers. SECTION 2 Page 12 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds b. Revenue Budget FY 2008-2009 REVENUE BUDGET ORGANIZATION PROJECTIPROGRAM CommittedlRestricted Funds (specify source) Non-CommittedlRestricted Funds (specify source) TOTAL Further Comments/Explanations (if necessary): Teen Esteem currently operates from individual contributions and therefore does not have restricted funds at this time. SECTION 2 Page 13 of21 City of Dublin Fiscal Year 1008-1009 Application for Funds 6. General Agency Information X Past grant applicants may check this box in lieu of completing item 6 (a-d) if the program/organizational description on file with the City is correct and current. a. List all years that Organization has previously received City of Dublin funding (not Community Development Block Grant - CDBG). NA b. Describe the population(s) served by the Organization. Students and parents c. Describe all the services the Organization currently provides to Dublin residents. · An additional page may be added, if needed. Middle school and high school dassroom presentations Parent Education d. Has your agency ever previously received funds from the City of Dublin? If yes, please specify in what Fiscal Years and the amount received each year. No SECTION 2 Page 14 of21 City of Dublin Fi~aIYear200~2009 Application for Funds 7. Required Attachments: o Onlv one (1) copv per A2encv of each ofthe following is required, even with multiple projects/programs submitted. o Applications without the following documents will not be reviewed for funding. o Please label attachments: A. B. C. etc. A. Names of Governing Board; identify current Board officers. ;4' Ji B. Current total Organization operating budget, including revenue. · Clearly label/identify the program that includes the PROPOSED PROJECTIPROGRAM. fA C. Most recent audit report or tax return (if applicable). ].a: D. Resolution, letter or other document providing evidence of Board/Organization approval of application, and date approval was granted. · Board/Organization approval may be pending. )Xl. E. Organization's certificate of insurance showing coverage for liability and workers' compensation. P. F. Application Verification Declaration Signature Page. D G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). )( H. Copy of IRS Letter of Determination indicating tax exempt status. SECTION 2 Page 15 of21 City of Dublin Fiscal YeaT 1008-1009 Application for Funds ApPLICATION VERIFICATION I attest that the information contained in this FY 2008-2009 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 30, 2009. Failure to submit a report will result in ineligibility for future funding. Signatures: I /dC,)U [3 . , Date ~ Board President/Chairperson J 6." U a..r t' < 4 J <..oD8 Date SECTION 2 Page 16 of21 City of Dublin Fiscal Year 2008-2009 Application for Funds COLLABORATION AGENCY AFFIDAVIT FORM o This form is to be completed by each collaborating organization as named by the applicant agency in the proposed project/program. o Completed forms must be submitted at time of application. Collaborating Agency Name: Agency Division/Department: Project/Program Title: Project/Program Role Description (i.e., facility space, staff support, etc.): Agency Project/Program Contact Person Title Phone Email I attest that the applicant agency and our organization agree to work collaboratively to implement the proposed project/program as identified in the FY 2008-2009 funding application. Executive Director Date Project/Program Contact Person Date SECTION 2 Page 17 of21 CITY OF DUBLIN Fiscal Year 2008-2009 COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM REQUEST FOR REIMBURSEMENT AGENCY NAME MAILING ADDRESS FOR REIMBURSEMENT: PROJECTIPROGRAM NAME CLAIM # OF TOTAL FUNDING AMOUNT AWARDED TOTAL REIMBURSEMENT REQUESTED THIS PERIOD $ $ Expense Type (please describe.) Date Amount of Reimbursement Requested (Please attach receipts, time sheets, etc. supporting identified expenses.) TOTAL Amount Requested (If requesting project/program "start-up" funding, please describe initial funding use above.) I attest that the above listed expenses are accurate and true and have been used as represented in the approved funding application. Submitted by: Signature: Date: SECTION 2 Page 180f21 CITY OF DUBLIN Fiscal Year 2008-2009 COMMUNITY GROUP/ORGANIZATIONAL FUNDING PROGRAM SUMMARY REpORT (Summary Report must be completed and submitted prior to August 31, 2009.) AGENCY NAME MAILING ADDRESS: TELEPHONE: PROJECT/PROGRAM NAME: TOTAL FUNDING AMOUNT AWARDED $ TOTAL REIMBURSEMENT RECEIVED $ 1.) How has the PROJECT/PROGRAM addressed an unmet community need and improved the quality of life for Dublin residents. (Additional page may be added, if needed): 2.) Please evaluate the success of your project/program. Were the goals outlined in the application met? Was the project/program carried out efficiently? Please use the objectives identified in your application to discuss your program/project's success and impact. Include any documentation!data/records you have that support your conclusions. SECTION 2 Page 19 of21 City of Dublin Fiscal Year 2008-2009 SUMMARY REpORT 3) How many total participants were served by this project/program? How many of those participants are Dublin residents? I attest that the above listed information is accurate and true. Submitted by: Signature: Date: SECTION 2 Page 20 of21 AGREEMENTBET~EN CITY OF DUBLIN AND (insert organization name) THIS AGREEMENT, dated for identification this _ day of _ 2008, is entered into between the City of Dublin ("City") and (organization). RECITALS A. (organization) has asked City to contribute $ ( Dollars) for use by (organization) to cover costs in order to provide the services as described in Exhibit A. The services rendered pursuant to this agreement will be for the period July 1,2008 through June 30, 2009. B. City has determined that it is in the interest of the residents of the City of Dublin to make a donation of $ ( Dollars) for such purpose, provided certain conditions are met to ensure that the services will benefit the residents of City. AGREEMENT City and (organization) agree as follows: 1. Recitals The foregoing recitals are true and correct and are part of this agreement. 2. City Donation City shall donate $ ( Dollars) to be used by (organization) to be used for operational support for as described in Exhibit A to this Agreement. The donation shall be paid upon invoice to the City. 3. Records (Organization) shall maintain records for project/program review, evaluation, audit and/or other purposes and make them available to City upon request. 4. Periodic Reports Upon request by City, (organization) shall provide reports describing the progress made by (organization) accomplishing the goals and objectives outlined in the work plan. CITY OF DUBLIN Dated: By: Richard C. Ambrose, City Manager Dated: By: Title: SECTION 2 Page 21 of 21 TEEN ESTEEM BOARD MEMBERS Tim Barley 7106 Johnson Dr. Pleasanton, 94588 Work 846-6622 x21 Cell 510-508-7629 Linda Turnbull 85 Highbridge Ct. Danville,94526 Home 743-0438 Cell 497-0530 linda@teenesteem.com Tom Mason 55 Starmount Lane Danville,94526 Home 314-3006 Cell 785-8825 tr _mason@msn.com Becky Pine 9 Country Oak Lane Alamo, 94507 Home 820-3334 Janyce Hoyt 55 Golden Meadow Lane Alamo, 94507 Home 838-5459 Cell 683-4417 dajrnem6@aol.com 1-08 QIO = = N ... r-. E-o [;oil e,:, Q ., '" =... '" -'>> ~ ~ ~'s '" ... '>: ';;;~~ .. < ;;: ~:;~ :; ;J r:L1 ...;j < - U Z < Z - r-. ~ o ,.. 00 ., " " ..., on 00 r- ., 00 < on 00 r- '" 00 l- i 00 '" ~ ~ ~ " " ..., t- ., '" ~ - " - ~ gin 5 ti Z "=: - StiG ~ :: \0 O~N ..... \0 ~ti~ lU -E O"l '" "=: ..... "<t " ..., t ~ ::.. " " < "=: on r--_r- <9 g ~ "'3 t:i ..., "=: ..... 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A For the 2006 calendar ear, or tax ear be innin 7/01 ,2006, and endin 6/30 B Check if applicable: C D Employer Identification Number Address change ~IRS~:~~e Teen Esteem Name change ~~/'y~~~ 85 Highbridge Court Se~f' Danville, CA 94526 Initial return specllc instruc- tions. Form 990 F mal return Amended return Application pending · Section 501 (c)(3) organizations and 4947(aXl) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ). G Web site: ~ N/A J Organization type (check onl one)......... ~ X 501 (c) 3 ~ (insert no.) 4947(a)(1) or 527 K Check here ~ if the organization is not a 509(a)(3) supporting organization and its gross receipts are normally not more than $25,000. A return is not required, but if the organizatIOn chooses to file a return, be sure to file a complete return. R E V E N U E (A) Securities 9a 9b E X P E N S E S 20-1598494 E Telephone number OMS No. 1545-0047 2006 Open to Public Inspection , 2007 F ~~~~~ming Cash Other (specify) ~ I M [R] No ONO No H and I .are not applicable to section 527 organizations. H (a) Is this a group return for affiliates? . . 0 Yes H (b) If 'ves,' enter number of affiliates ~ H (C) Are all affiliates included? . . . . . . . 0 Yes (If 'No,' attach a list. See instructions.) H (d) Is thiS a separate return filed by an organization covered by a group ruling? Grou Exemption Number. .. ~ Check ~ if the organization is not required to attach Schedule B (Form 990, 990-EZ, or 990.PF). See the instructions. (B) Other Gross recei ts: Add lines 6b, 8b, 9b, and lOb to line 12... ~ 133,715. Revenue Ex enses and Chan es in Net Assets or Fund Balances 1 Contributions, gifts, grants, and similar amounts received: a Contributions to donor advised funds. . . . . . . . . . . . . . 1 a b Direct public support (not included on line 1 a). . . . . . . . . . . . . . . . 1 b c Indirect public support (not included on line 1a).... ........... 1 c d Government contributions (grants) (not included on line 1 a). . . . . . . . . . . 1 d e m~r~~~~ 11~)s(CaSh $ 103, 656. noncash $ ). . . . . . . . . . , . . . . . . 2 Program service revenue including government fees and contracts (from Part VII, line 93)....... 3 Membership dues and assessments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Interest on savings and temporary cash investments. . . . . . . . . . . . . . . . . . . . . . . 5 Dividends and interest from securities. . . . . . . . . . . . . . . . . . . . . . . . . 6 a Gross rents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 a b Less: rental expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 6 b c Net rental income or (loss). Subtract line 6b from line 6a. . . . . . . , . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . 7 Other investment income (describe. . . . . . .. ~ S a Gross amount from sales of assets other than inventory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sa b Less: cost or other basis and sales expenses. . . . . . . 8b c Gain or (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . 8 c d Net gain or (loss). Combine line 8c, columns (A) and (8) . . . . . . . . . . . . . . . . . 9 Special events and activities (attach schedule). If any amount is from gaming, check here. a Gross revenue (not including $ 39, 806. of contributions reported on line 1 b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less: direct expenses other than fundraising expenses. . . . . . . . . c Net income or (loss) from special events. Subtract line 9b from line 9a. . . . . . lOa Gross sales of inventory, less returns and allowances. . . . . . . . . . . . . . .. lOa b Less: cost of goods sold........................ lOb c Gross profit or (loss) from sales of inventory (attach schedule). Subtract line lOb from line lOa. . 11 Other revenue (from Part VII, line 103). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Total revenue. Add lines 1 e, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Program services (from line 44, column (8)). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Management and general (from line 44, column (Cn . . . , . . . . . . . . . . .. . ,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Fundraising (from line 44, column (D))........ ................. .... ...n.. 16 Payments to affiliates (attach schedule) . . . . .. ..................... . . . . . . . . . ,. . 17 Total ex enses. Add lines 16 and 44, column (A)....... . . . .. l~ .L. A 18 Excess or (deficit) for the year. Subtract line 17 from line 12. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ ~ 19 Net assets or fund balances at beginning of year (from line 73, column (A)). . . . . . . . . . . . . . T ~ 20 Other changes in net assets or fund balances (attach explanation) . . . . . . . s 21 Net assets or fund balances at end of year. Combine lines 18, 19, and 2Q BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. 103,656. ~D 30 059. 30,059. S.tatement. .1 10c 11 12 13 14 15 16 17 18 19 20 21 TEEA0109L 01/22107 103 656. 103,656. 109,453. 7,452. 116,905. -13,249. 41,515. 28,266. Form 990 (2006) Form 990 (2006) Teen Esteem 20-1598494 Pa e 2 Statement of Functional Expenses All organizations must complete column (A). Columns (B), (C) ,and (D) are required for section 501 (c)(3) and (4) organizations and section 4947(a)(1) nonexempt cnaritable trusts but optional for others. Do not include amounts reported.on line 6b, 8b, 9b, 70b, or 76 of Part I. 22a Grants paid from donor advised funds (attach sch) (cash $ non.cash $ If this amount includes foreign grants, check here.. ~ D. . . .. 22a 22 b Other grants and allocations (att sch) (cash $ non.cash $ If this amount includes foreign grants, check here.. ~ D. . . 22b 23 Specific assistance to individuals (attach schedule) . . . . . . . . . . . . . . 23 24 Benefits paid to or for members (attach schedule). . . 24 25a Compensation of current officers, directors, key employees, etc listed in Part V.A (attach sch)........ 25a b Compensation of former officers, directors, key employees, etc listed in Part V.B (attach sch). . . . . . . . . . . . . . . . .. 25 b c Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) (attach schedule). . . . . . . . . . 25c 26 Salaries and wages of employees not included on lines 25a, b, and c. . . (A) Total (B) Program services 50,000. 50,000. O. O. O. O. O. o. o. O. O. O. 26 36,477. 36,477. 27 Pension plan contributions not included on lines 25a, b, and c. . . 27 28 Employee benefits not included on lines 25a - 27. . . . . . . . . . . . 28 29 Payroll taxes. . . . . . . . . . . 29 30 Professional fundraising fees. . . 30 31 Accounting fees. . . . . . . . . . . .. 31 32 Legal fees. 32 33 Supplies............. 33 34 Telephone..... 34 35 Postage and shipping. . . . . . . . . . . . . . . . 35 36 Occupancy...................... 36 37 Equipment rental and maintenance. . . .. 37 38 Printing and publications. . . . . . . . . . . . . . 38 39 TraveL...... . . . . . . . . . . . . . . . . . . . . .. 39 40 Conferences, conventions, and meetings. . . . . . .. 40 41 Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 41 42 DepreciatIOn, depletion, etc (attach schedule) . . 42 43 other expenses not covered above (itemize): a See Statement 2 ------------------ b d 43a 43b 43c 43d 43e 43f 43 8,213. 8,213. 4,550. 4,550. 90l. 90l. 1,056. 1,056. 297. 297. 2,190. 2 190. 599. 599. 210. 210. 12,412. 10,017. 2,395. c e f 9 44 Total functional expenses. Add lines 22a through 43g. (Organizations completing columns (B) - (0), carr these totals to lines 13 . 15). . . .. 44 Joint Costs. Check. ~ if you are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? . . . . .. ~O Yes [2g No If 'Yes.,' enter (i) the aggregate amount of these joint costs $ ; (ii) the amount allocated to Program services $ ; (iii) the amount allocated to Management and general $ ; and (iv) the amount allocated 116 905. 109 453. 7 452. o. to Fundraising $ BAA TEEA0102L 01/23/07 Form 990 (2006) Form 990 (20.0.6) Teen Esteem 20-1598494 Pa e 3 Ra1'tl1wltl[f~~j Statement of Pro ram Service Accom Iishments Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. What is the organization's primary exempt purpose? . Program Service Expenses All organizations must describe their exempt purpose achleVerrH3nts Tn a clear and conCISe manner. State the- number-of (Re(~)'~~~~~~Z~?i~~i(;~J'nd ~lteDts served, publications issued, etc. Discuss achievements that are not measurable. (Section 50.1 (c) (3) and (4) organ- 4947(a)(l) trusts; but Izatlons and 4947(a)(1) nonexempt charitable trusts must also enter the amount of rants and allocations to others.) oplional for others.) a]~~n_ ~~t_e~1!!. _WE~ _o.fqa_nl~e_d_ fOJ_ ~h_e_E.~1?2.s_e_ 2.~ ~Q.U_cE~i_ngL. ~g~i.pl~cr. E~d_ _. _e~E.o_w~~i1l9 _ t_e~~C!9'~ _ s_t~Q.~!:~ _aEQ. .PE~~n!:~ _t.2 _m_at~ J1~~l_ttly. _CE2.i_c~~ J.E _ t_h~. ~.f~~_2.~2~~_Q.r~g~~EQ.~1~0J1.2h~___________________________-. -----------------------------------------------------. ---------------------------------------------------- (Grants and allocations $ If this amount includes foreign rants, check here. .. ~ b 109,453. -----------------------------------------------------. ------------------------------------------------------ ------------------------------------~----------------- ------------------------------------------------------ ---------------------------~------------------------ ) If this amount includes forei n rants, check here. .. ~ (Grants and allocations $ c ------------------------------------------------------ ------------------------------------------------------ ------------------------------------------------------ ------------------------------------------------------ ---------------------------------------------------- ) If this amount includes foreign grants, check here. .. ~ (Grants and allocations $ d ------------------------------------------------------ -----------------------------------------------------~ -----------------------------------------------------. ----------------.-------------------------------------. ---------------------------------------------------- (Grants and allocations $ e Other program services. . . . . . . . . . . . . . . . . . . . . . . (Grants and allocations $ ) If this amount includes forei n rants, check here. .. ~ f Total of Program Service Expenses (should equal line 44, column (8), Program services). , . . . . . . BAA ) If thiS amount includes foreign rants, check here. . ~ 109,453. Form 990 (20.0.6) TEEAO 1 03L 01/18/07 Form 990 (2006) Teen Esteem Balance Sheets See the instructions. Note: Where required, attached schedules and amounts within the description column should be for end-of.year amounts only. 45 Cash - non-interest-bearing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Savings and temporary cash investments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 a Accounts receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less: allowance for doubtful accounts. . . . . . . . . . . . . . 530. 48a Pledges receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less: allowance for doubtful accounts. . . . . . . . . . . . .. 48b 49 Grants receivable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A S S E T S 50 a Receivables from current and former officers, directors, trustees, and key employees (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described In section 4958(c)(3)(B) (attach schedule) . 51 a Other notes and loans receivable (attach schedule) . . . . . . . . . . . . . 51 a b Less: allowance for doubtful accounts. . 51 b 52 Inventories for sale or use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Prepaid expenses and deferred charges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54a Investments - publicly.traded securities. . . . . . . . . . . . . . . .. ~ 0 Cost 0 FMV b Investments - other securities (attach sch). . . . . . . . . . . . .. ~ 0 Cost 0 FMV 55a Investments - land, buildings, & equipment: basis.. 55a b Less: accumulated depreciation (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Investments - other (attach schedule) . 57 a Land, buildings, and equipment: basis. . . . . . . . 55b 57a 1,139. L I A B I L I T I E S b Less: accumulated depreciation (attach schedule)............ .Statement. .3.... 57b 58 Other assets, including program-related investments (describe ~ ...?~~ _S.!~~e.!!.l~n_t_ i _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _) . 59 Total assets (must equal line 74). Add lines 45 through 58. . . . . 60 Accounts payable and accrued expenses. . . . . . . . . . . . . . . . . . . . . . . 61 Grants payable. . . . . . . . . . . . . . . . . . . . . . . . . 62 Deferred revenue. . . . . . . . . . . . . . . . . . . . . 747. 63 Loans from officers, directors, trustees, and key employees (attach schedule). . . . 64a Tax.exempt bond liabilities (attach schedule) . . . b Mortgages and other notes payable (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Other liabilities (describe .... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _) . 66 Total liabilities. Add lines 60 through 65. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N Organizations that follow SFAS 117, check here ~ IKI and complete lines 67 f through 69 and lines 73 and 74. A 67 Unrestricted................................................................. ~ 68 Temporarily restricted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 69 Permanently restricted. . . . . . . . . . o Organizations that do not follow SFAS 117, check here ~ 0 and complete lines R F 70 through 74. ~ 70 Capital stock, trust principal, or current funds. . . . . . . . . .. ..... o B 71 Paid.in or capital surplus, or land, building, and equipment fund. . f 72 Retained earnings, endowment, accumulated income, or other funds. A N C E S 73 Total net assets or fund balances. Add lines 67 through 69 or lines 70 through 72. (Column (A) must equal line 19 and column (B) must equal line 21). . 74 Total liabilities and net assetslfund balances. Add lines 66 and 73. . . . . . . . BAA TEEA0104L 01/18/07 20-1598494 (A) Beginning of year 41,814. 48c 49 50a SOb Pa e 4 (B) End of year 26,913. 530. 515. S7c 392. 58 2, DOl. 42,329. 59 29,836. 814. 60 1,570. 61 62 814. 41 515. 41 , 515. 73 42,329. 74 1,570. 28 266. 28,266. 29,836. Form 990 (2006) Form 990 (2006) Teen Esteem 20-1598494 Page 5 1!~a!~~II~~~l Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See the instructions.) Add lines dl and d2 . . . . . . . . . . . . . . . . . . . . . . . . .. ............................... . . . . . . . . . . . . . . . . . . . . d Totalexenses(Partl,line17).Addlinescandd............ ............. ............. ~ e 116,905. Current Officers, Directors, Trustees, and Key Employees (List each person who was an officer, director, trustee, or key employee at any time during the year even if they were not compensated.) (See the instructions.) (B) Title and average hours (C) Compensation (0) Contributions to (E) Expense per week devoted (if not paid, employee benefit account and other to position enter -0-) plans and deferred allowances compensation plans O. a b Total revenue, gains, and other support per audited financial statements. Amounts included on line a but not on Part I, line 12: 1 Net unrealized gains on investments. . . . . . . . . . 2Donated services and use of facilities. . . . . . . 3Recoveries of prior year grants. . . . . . . . . . . 40ther (specify): __ _ __ __ _ _ _ __ _ _ ___ _ _ __ _ _ _ _ _ _ _ __ bl b2 b3 b4 c d Add lines bl through b4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtract line b from line a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Amounts included on Part I, line 12, but not on line a: 1 Investment expenses not included on Part I, line 6b.. ........................... dl 20ther (specify): ___ _ __ _ ___ _ _ _ _ _ _ _ __ __ ___ __ ____ a b Total expenses and losses per audited financial statements. . . . Amounts included on line a but not on Part I, line 17: 1 Donated services and use of facilities. . . . . . . . . . . . . 2 Prior year adjustments reported on Part I, line 20. . . . . . . 3losses reported on Part I, line 20. . . . . . . . . . . . . . . . . . . . . . . 40ther (specify): _ __ ___ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ ___ bl b2 b3 b4 c d Add lines bl through b4. . . . . . . . . . . . . . Subtract line b from line a. . . . . . . . . . . . . . . . Amounts included on Part I, line 17, but not on line a: 1 Investment expenses not included on Part I, line 6b....................... 20ther (specify): _ __ _ _ _ _ _ ___ _ _ ___ _ ____ _ __ _ _____ b c dl I d2 e (A) Name and address ~~~~~!~rQ~~~__________ 3~_H5g~bJl~~~~~________ Danville, CA 94526 ~E~c~_~oy~____________ 3~_H5g~~~~~~~~________ Danville, CA 94526 ]~IE. J3EE.l_ey_____________ 3~_H5g~bJ~~~~~~________ Danville, CA 94526 J3~~kJ_~~n~_____________ 3~_H5g~bJ~~~~~~________ Danville, CA 94526 ].2IE. _ME~o_n___ _ _ ___ _ _ _ ___ 3~_H5g~bJ~~~~~~________ Danville, CA 94526 Rick Weisser --------------------- 3~_H5g~~~~~~~~________ Danville, CA 94526 BAA President 35 50,000. 103,656. 103,656. 103,656. 116,905. 116,905. o. Secretary O. O. O. 10 Vice President O. O. O. 5 Director O. O. O. 0 Director O. O. O. 0 Director O. O. O. 0 TEEA0105l 01/18/07 Form 990 (2006) Form 990 (2006) Teen Esteem 20-1598494 !~'iJi1t)!~#~ Current Officers Directors, Trustees and Ke Em 10 ees continued 75 a Enter the total number of officers, directors, and trustees permitted to vote on organization business as board meetings. ~ _6_ _ _ _ _ _ _ _ _ _ b Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed In Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule ~, Part II.A or II.B! related to each other through family or business relationships? If 'Yes,' attach a statement that I entlfles the individuals and explains the relatlonshlp(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . c Do any officers, directors, trustees, or key employees listed in form 990, Part V -A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or 11.8, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization? See the instructions for the definition of 'related organization'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If 'Yes,' attach a statement that includes the information described in the instructions. d Does the or anization have a written conflict of interest olic?..................................................... 75 d X I?;~n!!~~al~, Former Officers, Directors, Trustees, and Key Employees That Received Compensation or Other Benefits (If any former officer, director, trustee, or key employee received compensation or other benefits (described below) during the year, list that person below and enter the amount of compensation or other benefits in the appropriate column. See the instructions.) (C) Compensation (0) Contributions to (E) Expense (A) Name and address (B) Loans and (if not paid, employee benefit account and other Advances enter -0.) plans and deferred allowances compensation plans None return? . . Other Information See the instructions.) 76 Did the organization make a change in its activities or methods of conducting activities? If 'Yes,' attach a detailed statement of each change. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Were any changes made in the organiZing or governing documents but not reported to the IRS? If 'Yes,' attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by thi b If 'Yes,' has it filed a tax return on Form 990-T for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l: 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If 'Yes,' attach a statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 a I s the organization related (other than by association with a statewide or nationwide organization) through co man membership, governing bodies, trustees, officers, etc, to any other exempt or nonexempt organization? . . .. ........ b If 'Yes,' enter the name of the organization ~ N/A ______________________::_~~~~-~d~~k~~~;~~-D~~;~;--On~~;mpt. 81 a Enter direct and indirect political expenditures. (See line 81 Instructions.)................. 81 a O. b Did the or anization file Form 1120-POL for this ear? . . . . . . . . . . . . . . . . . . . . . . . . . . .. .......... BAA TEEA0106L 01/18/07 20-1598494 Page 7 Yes No 9 For supporting organizations and sponsoring organizations maintaining donor advised funds. Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year? . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 a List the states with which a copy of this return is filed ~ _ f~ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - - b ~SUe~bi~~t~SZt~~I~.)ees. e~PIOye~ .in th~pay .perio.d that .includes ~arch12,. 2006 . . . . .. ~ 0 91 a The books are in care of ~ Linda Turnbull Telephone number ~ Jl2~-J~~-J:l~~8_ ~ _ - - - -- Located at ~ Jl~ _HJ.g~bJl:~~~ ~(;~Q:"~.Yi)}~~ ]:~~ ~ ~ ~ ~ ~ ~ = _ _ _ _ _ _ _ _ _ _ _ _ ZIP-+ 4 ~ Jl~~2_6_ - -- - --- 82 a Did the or~anization receive donated services or the use of materials, equipment, or facilities at no charge or at substantia Iy less than fair rental value? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b If 'Yes,' you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions in Part IlL) . . . . . . . . . . . . . . .. 82b 83a Did the organization comply with the public inspection requirements for returns and exemption applications? . b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? . . . . . . . . . . . 84a Did the organization solicit any contributions or gifts that were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b If 'Yes,' did the or~anization include with every solicitation an express statement that such contributions or gifts were not tax deductible.. . . . . . . . . . . . . .. ...........,.................................................................... 85 501 (c)(4), (5), or (6) organizations. a Were substantially all dues nondeductible by members? . b Did the organization make only in-house lobbying expenditures of $2,000 or less? . . . . . . . . . . . . . . If 'Yes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. e Dues, assessments, and similar amounts from members. . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . .. 8Se d Section 162(e) lobbying and political expenditures. . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . , . .. 8Sd e Aggregate nondeductible amount of section 6033(e)(1 ) (A) dues notices, . . . . . . . . . . . . . . . . ., 8Se t Taxable amount of lobbying and political expenditures (line 85d less 85e) , . . . . , . . , , . , . . , .. 85t 9 Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? . . . . . . . . . . . . . . , . . . . h If section 6033(e)(1 )(A) dues notices were sent, does the organization agree to add the amount on line 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? . . . . . , . . . . . , . . . . . . . . . . . . . . . . . , . 86 501 (c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 12........ .. ............ ....".....,................... ..... 86a b Gross receipts, included on line 12, for public use of club facilities. . 86b 87 501 (c)(12) organizations. Enter: a Gross income from members or shareholders. 87a b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.), . . . . . . . . ,. ........... 87b , 88 a At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701.2 and 301.7701-3? If 'Yes,' complete Part IX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)? If 'Yes,' complete Part XL.. ............. ............... ...................................... 89 a 501 (c)(3) organizations, Enter: Amount of tax imposed on the organization during the year under: section 4911 ~ _ _ _ _ _ _ _ _ _ .2:... ; section 4912 ~ _ _ _ _ _ _ _ _ _ ..9.:. ; section 4955 ~ _ _ _ _ _ _ _ _ _ ..9 .:. b 501 (c)(3) and 501 (c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If 'Yes,' attach a statement explaining each transaction. . . . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . e Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958...,..,.,........................,.........,.... .. ~ O. d Enter: Amount of tax on line 89c, above, reimbursed by the organization. . . . . . , . . . . . . . . . . . .. ~ O. e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? t All organizations. Did the organization acquire a direct or indirect interest in any applicable insurance contract? . . b At any time during the calendar year, did the organization have an interest in or a signature .or other authority over a finanCial account In a foreign country (such as a bank account, securities account, or other finanCial account)? , . . . . . . . . If 'Yes,' enter the name of the foreign country. ., ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ See the instructions for exceptions and filing requirements for Form TO F 90-22.1, Report of Foreign Bank and Financial Accounts. BAA Form 990 (2006) TEEA0107L 01/18/07 Form 990 (2006) Teen Esteem 20-1598494 '~P'ai1:~I'~: Other Information (continued) c At any time during the calendar year, did the organization maintain an office outside of the United States? . . 91 c If 'Yes,' enter the name of the foreign country. .. ~ 92 Section 4947(a)(1) nonexempt charitable trusts fi/;;'i F-;~ -990fn-li-;u-of Fo-;'';; 7047 ~ Che~k-h;r; - - - - - -: -::-: ~ -::-: ~N7.A .-:-':-0 ... . ,.. . ~I. ~2 I . . and enter the amount of tax.exemDt interest received or accrued during the tax year. . . . . . . . . . . . .... . . . N/A w;~~rttJj"II;ji Analysis of Income-Producina Activities (See the instructions.) Unrelated business income Excluded bv section 512,513, or 514 (E) Note: Enter gross amounts unless (A) (B) (C) (0) Related or exempt otherwise indicated. Business code Amount Exclusion code Amount function income 93 Program service revenue: a b c d e f Medicare/Medicaid payments. ..... , 9 Fees & contracts from government agencies. . . 94 Membership dues and assessments. . 95 Interest on savings & temporary cash invmnts. . 96 Dividends & interest from securil1es . 97 Net rental income or (loss) from real estate: ".., ".T'....... ',....,.,...,,<,.... .,". .... ...,. ".'N,.,<<.j/': ,.".';.).......... T.......,.'? }, a debt-financed property. . . . . . . . . . . . . . . b not debt-financed property. . . . . . . . . . . 98 Net rental income or (loss) from pers prop. . . . 99 Other investment income. . . . . . . . . . . . 100 Gain or (loss) from sales of assets other than inventory. . . . . . . . . . . . . . . . . 101 Net income or (loss) from special events. . . . . . 102 Gross profit or (loss) from sales of Inventory. . . . . 103 Other revenue: a .T ,.":;,;,,,.','.;,,H? .,);;:,:;.,; "".'/ .................,...,." ;"';.},,"',, . ...,t.!>j; ./.,;. :H b c d e 104 Subtotal (add columns (B), (0), and (E)) . . .........,.,}?...,':..", i i":"" ., ",,'.':',}. 105 Total (add line 104, columns (8), (D), and (E))........... Note: Line 705 plus line Ie, Part I, should equal the amount on line 12, Part I. l~a~(NlIlI Relationshi of Activities to the Accom lishment of Exem ~ o. See the instructions. Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment .... of the organization's exempt purposes (other than by providing funds for such purposes). N/A :;'Fti(l!fi:!I*!! Information Re ardin Taxable Subsidiaries and Disre arded Entities See the instructions. (A) (B) (C) (0) (E) Name, address, and EIN of corporation, partnership, or disregarded entity Percentage of ownership interest Nature of activities Total income End.of.year assets N/A % % Information Re ardin Transfers Associated with Personal Benefit Contracts a Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . b Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?.. Note: If 'Yes' to (b), file Form 8870 and Form 4720 (see instructions). BAA TEEAOlOBL 04/04/07 % % Form 990 (2006) Form 990 (2006) Teen Esteem 20-1598494 1.;*.el:l'ij1~I;s'.llnformation Regarding Transfers To and From Controlled Entities. Complete only if the organization is a controlling organization as defined in section 57 2(b) (7 3). Page 9 Yes No 106 Did the reporting organization make any transfers to a controlled entity as defined in section 512(b)(13) of the Code? If 'Yes,' com lete the schedule below for each controlled entit ............................................................ X (A) Name, address, of each controlled entity (B) . Employer Identification Number (C) Description of transfer (D) Amount of transfer a b c Totals Yes No 107 Did the reporting organization receive any transfers from a controlled entity as defined in section 512(b)(13) of the Code? If 'Yes,' com Jete the schedule below for each controlled entit ............................................................ X (A) Name, address, of each controlled entity (B) Employer Identification Number (C) Description of transfer (D) Amount of transfer a ------------------------- b c ------------------------- Totals Yes No 108 Did the organization have a binding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and annuities described in question 107 above? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . X Under penalties Of perjury, I declare that I have examined thiS return, 1n,luding accompanYing schedules, and statements, and to the best of my knowledge and belief, It is true, correct. and complele. Declaration of preparer (other than officer), IS based on all Informallon of which preparer has any knowledge. Signature of officer ~ Linda Turnbull, President Type or pflnt name and title. (C(Q)~V Date Please Sign Here ~ Firm's name (or yours if self. employed), ~ address, and ZIP + 4 Check If self. employed ~ Preparer's SSN or PTIN (See Generallnstrucllon W) P00139244 Paid Pre- parer's Use Only BAA Preparer's ""- sIgnature JIll""'" Pretis, LLP 5820 Stonerid e Mall Rd Stel13 Pleasanton, CA 94588 EIN ~ 94-3334028 Phone no ~ (9 2 5 ) 92 4 -15 0 0 Form 990 (2006) TEEA0110L 01/19/07 Department of the Treasury Internal Revenue Service Name of the organiZation Organization Exempt Under Section 501 (cX3) (Except Private Foundation) and Section 501(e), 501(f), 501(k), 501(n), or 4947(a)(1) Nonexempt Charitable Trust Supplementary Information - (See separate instructions.) ~ MUST be completed by the above organizations and attached to their Form 990 or 990-EZ. OMS No.1 545.0047 SCHEDULE A (Form 990 or 990-EZ) 2006 Employer identification number Esteem 20-1598494 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See instructions. List each one. If there are none, enter 'None.') (a) Name and address of each (b) Title and average (c) Compensation employee paid more hours per week than $50,000 devoted to position (d) Contributions to employee benefit plans and deferred compensation (e) Expense account and other allowances None ------------------------- Total number of other employees paid over $50,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ 0 Compensation of the Five Highest Paid Independent Contractors for Professional Services (See instructions. List each one (whether individuals or firms). If there are none, enter 'None.') (a) Name and address of each independent contractor paid more than $50,000 None (b) Type of service (c) Compensation ---------------------------------------- ---------------------------------------- ---------------------------------------- ---------------------------------------- -----~---------------------------------- Total number of others receiving over $50.000 for professional services. . . . . . ~ 0 paiit!'Uli.;ciS" Compensation of the Five Highest Paid Independent Contractors for Other Services (List each contractor who performed services other than professional services, whether individuals or firms. If there are none, enter 'None.' See instructions.) (a) Name and address of each independent contractor paid more than $50,000 None (b) Type of service (c) Compensation ---------------------------------------- ---------------------------------------- ---------------------------------------- ---------------------------------------- ---------------------------------------- Total number of other contractors receiving over $50,000 for other services. . . . . . . . . . . ~ 0 BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2006 TEEA0401L 01119/07 Schedule A (Form 990 or 990.EZ) 2006 Teen Esteem 20-1598494 I,j~!i!liitt\\nl'iir;:',~~'l Statements About Activities (See instructions.) 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities. . .. ~ $ N / A (Must equal amounts on line 38, Part VI.A, or line i of Part Vi-B.)................................... ........ Organizations that made an election under section 501 (h) by filing Form 5768 must complete Part VI-A. Other organizations checking 'Yes' must complete Part VI.B AND attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxableorganization with which any such person is affiliated as an officer, director, trustee, majority owner, or prinCipal beneficiary? (If the answer to any question is 'Yes,' attach a detailed statement explaining the transactions.) a Sale, exchange, or leasing of property? . . . b Lending of money or other extension of credit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Furnishing of goods, services, or facilities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Payment of compensation (or payment or reimbursement of expenses if more than $1 ,OOO)? . . . . . . . . . . . . . . . . . . . e Transfer of any part of its income or assets? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a Did the organization make grants for scholarships, fellowships, student loans, etc? (If 'Yes,' attach an explanation of how the organization determines that recipients qualify to receive payments.). . . . . . . . . . . . . . . . . . . . . . . b Did the organization have a section 403(b) annuity plan for its employees? . . . . . . . . . . . . . . . . . . c Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures? If 'Yes,' attach a detailed statement. . . . . . . . . . . . . . . . . d Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services? . 4a Did the organization maintain any donor advised funds? If 'Yes,' complete lines 4b through 4g. If 'No,' complete lines 4f and 4g. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Did the organization make any taxable distributions under section 4966? . . . . . . . . . . . c Did the organization make a distribution to a donor, donor advisor, or related person? . . . d Enter the total number of donor advised funds owned at the end of the tax yem . . . . . . . . . . e Enter the aggregate value of assets held in all donor advised funds owned at the end of the tax year. . . . . . . . . . f Enter the total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included on line 4d) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Enter the aggregate value of assets held in all funds or accounts included on line 4f at the end of the tax year. . . ~ Pa e 2 Yes No x ~ ~ ~ 2a x 2b x 2c x 2d x 2e x 3a x 3b x 3c x 3d x 4a x 4b N A 4c N A N/A N/A o BAA TEEA0402L 04/04/07 Schedule A (Form 990 or Form 990.EZ) 2006 o. Schedule A (Form 990 or 990-EZ) 2006 Teen Esteem I':~~"ittiilllf,:ih)l Reason for Non-Private Foundation Status (See instructions.) 20-1598494 Page 3 I certify that the organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 o A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i). 6 o A school. Section 170(b)(1 )(A)(ii). (Also complete Part V.) 7 o A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii). 8 o A federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). 9 o A medical research organization operated in conjunction with a hospital. Section 170(b)(1 )(A)(iii). Enter the hospital's name, city, and state ~ J_____________________________________________________-- 10 o An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV.A.) 11 a ~ An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11 b D A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV.A.) 12 D An organization that normally receives: (1) more than 33-113% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions - subject to certain exceptions, and (2) no more than 33.1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV -A.) 13 D An organization that is not controlled by any disqualified persons (other than foundation managers) and otherwise meets the requirements of section 509(a)(3). Check the box that describes the type of supporting organization: ~ DType I DType II DType 111.Functionally Integrated o Type III-Other Provide the following information about the supported organizations. (See instructions.) (a) (b) (c) (d) (e) Name(s) of supported Employer identification Type of . Is the supported Amount of organization(s) number (EIN) organization (described organization listed in support in lines 5 through 12 the supporting above or IRe section) organization's governing documents? Yes No Total.. ...... .. o. ~ An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.) BAA Schedule A (Form 990 or 990-EZ) 2006 TEEA0407L 01/22/07 Schedule A (Form 990 or 990.EZ) 2006 Teen Esteem. 20-1598494 Il?'aftW~~P~';i'l Support Schedule (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting. Note: You ma use the worksheet in the instructions for convertin from the accrual to the cash method of accountin Calc:nd~lr y~ar (or fiscal year (a) (b) (c) (d) begmnmg m).. . . . . . . . . . . . . ... . . .. ~ 2005 2004 2003 2002 15 Gifts, grants, and contributions received. (Do not include unusual rants. See line 28.). . 180, 973. 16 Membership fees received. . 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc, purpose. . . . . . . . . 18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organ- ization after June 30, 1975. . . . . Page 4 (e) Total 180,973. O. o. o. 19 Net income from unrelated business activities not included in line 18. . . . . 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf. . . . . . . . . . . 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the ublic without charge. . . . . . . 22 Other income. Attach a schedule. Do not include gain or (loss) from sale of capital assets. . . 23 Total of lines 15 through 22.. 180,973. 24 Line 23 minus line 17. 180,973. 25 Enter1%ofline23... 1,810. 26 Organizations described on lines 10 or": a Enter 2% of amount in column (e), line 24. . . . . . . . . . . b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental unit or publicly supported organization) whose total gifts for 2002 through 2005 exceeded the amount shown in line 26a. Do not file this list with your return. Enter the total of all these excess amounts. . . . . . . . . . . . . c Total support for section 509(a)(1) test: Enter line 24, column (e). d Add: Amounts from column (e) for lines: 18 19 22 26b e Public support (line 26c minus line 26d total) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Public su ort ercenta e line 26e numerator divided b line 26c denominator .................... 27 Organizations described on line 12: N/A a F or amounts included in lines 15, 16, and 17 that were received from a 'disqualified person,' prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person.' Do not file this list with your return. Enter the sum of such amounts for each year: (2005) _ _ _ _ _ _ _ _ _ _ _ _ (2004) _ _ _ _ _ _ _ _ _ _ _ _ (2003) _ _ _ _ _ _ _ _ _ _ _ _ (2002) _ _ _ _ _ _ _ _ _ _ _ _ - bFor any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of, and amount received for each year, that was more than the larger of (1) the amount on Ime 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11 b, as well as Individuals.) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year: (2005) _ _ _ _ _ _ _ _ _ _ _ _ (2004) _ _ _ _ _ _ _ _ _ _ _ _ (2003) _ _ _ _ _ _ _ _ _ _ _ _ (2002) _ _ _ _ _ _ _ _ _ _ - - - c Add: Amounts from column (e) for lines: 15 16 17 ~ ~ o. o. o. O. 180,973. 180,973. ~ 26b ~ 26c 180 973. 26d ~ 26e ~ 26f 180,973. 100.00 % d Add: Line 27a total. . . e Public support (line 27c total minus line 27d total) . f Total support for section 509(a)(2) test: Enter amount from line 23, column (e).. ~ 27f 9 Public support percentage (line 27e (numerator) divided by line 27f (denominator)). . . . . . . . . . . . . . ~ 27 h Investment income ercenta e line 18, column e numerator divided b line 27f denominator ~ 27h % 28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 2002 through 2005, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief descriplion of the nature of the grant. Do not file this list with your return. Do not include these grants in line 15. BAA TEEA0403L 01/19/07 and line 27b total. . 27c 27d ~ 27e Schedule A (Form 990 or 990-EZ) 2006 Schedule A (Form 990 or 990-EZ) 2006 Teen Esteem Private School Questionnaire (See instructions.) (To be completed ONLY by schools that checked the box on line 6 in Part IV) 20-1598494 Page 5 N/A Yes No --------------------------------------------------------- 29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the penod of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If 'Yes,' please describe; if 'No,' please explain. (If you need more space, attach a separate statement.) -------------------------------------------------------- --------------------------------------------------------- --------------------------------------------------------- 32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? . . . . . . b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32a 32b c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing With student admissions, programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Copies of all material used by the organization or on its behalf to solicit contributions? . . .. ... . . . . . . . . . . . . . . . . . . . If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.) --------------------------------------------------------- --------------------------------------------------------- 33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? . . 33a b Admissions policies? . . . . . . . . . 33b ...,.....,........,.....,...................,... . c Employment of faculty or administrative staff? . .,............................................ . 33c d Scholarships or other financial assistance? 33d e Educational policies? . . . 33e f Use of facilities? . . . . 33f h Other extracurricular activities? . . . . . . . . . . . . . . . . . . . . . . . . . ...................................,........... . 9 Athletic programs? . . ,.,....,.".,...."...",..",.."""."....,..,... , If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) --------------------------------------------------------- -------------------------------------------------------- --------------------------------------------------------- 34a Does the organization receive any financial aid or assistance from a governmental agency? . . . . . b Has the organization's right to such aid ever been revoked or suspended? If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev Proc 75-50, 1975.2 C.B. 587, covering racial nondiscrimination? If 'No,' attach an explanation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . BAA TEEA0404L 01/19/07 20-1598494 Page 6 N/A Check .. if ou checked 'a' and 'limited control' provisions a I. (a) (b) Affiliated group To be completed totals for all electing or anizations Limits on Lobbying Expenditures (The term 'expenditures' means amounts paid or incurred.) 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) . . 37 Total lobbying expenditures to influence a legislative body (direct lobbying). . . . . . . . . . 38 Total lobbying expenditures (add lines 36 and 37). . . . , . . . . . . . . . . . 39 Other exempt purpose expenditures. . . . . . . . . . . . . . . . . . . . . . . . . 40 Total exempt purpose expenditures (add lines 38 and 39) . . . . 41 Lobbying nontaxable amount. Enter the amount from the following table - If the amount on line 40 is - The lobbying nontaxable amount is - Not over $500,000. . . . . . . . . . . . . . . . . . . . . . 20% of the amount on line 40 . . . . . a Over $500,000 but not over $1,000,000. . . . . . . . . . . $100,000 plus 15% of the excess over $500,000 Over $1,000,000 but not over $1,500,000. . . . . , . . . . $175,000 plus 10% of the excess over $1,000,000 Over $1,500,000 but not over $17,000,000 . . . . . . . , . $225,000 plus 5% of the excess over $1,500,000 Over $17,000,000....................... $1,000,000....................... 42 Grassroots nontaxable amount (enter 25% of line 41) . . . . . . . . . . . . . . . . . . . . . . 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 . . . . . . . . . . . . . . . 44 Subtract line 41 from line 38. Enter -0. if line 41 is more than line 38. . . . . . . . . . . . . . . Caution: If there is an amount on either line 43 or line 44, au must file Form 4720. 4 -Year Averaging Period Under Section 501 (h) (Some organizations that made a section 501 (h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50.) Lobbying Expenditures During 4 .Year Averaging Period Calendar year (a) (or fiscal year 2006 beginning in) .. 45 Lobbying nontaxable amount. . . . 46 Lobbying ceiling amount (150% of line 45(e)). 47 Total lobbying ex enditures. 48 Grassroots non. taxable amount. . . . . . . 49 Grassroots ceiling amount (150% of line 48(e)). . . . . . 50 (b) 2005 (c) 2004 (d) 2003 (e) Total N/A During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Paid staff or management (Include compensation in expenses reported on lines c through h.). . . c Media advertisements. . . d Mailings to members, legislators, or the public. . . e Publications, or published or broadcast statements. . . . . . . f Grants to other organizations for lobbYing purposes. . . . . . . . . . . . . . . . . g Direct contact with legislators, their staffs, government officials, or a legislative body. . . . . . . . . . . . . h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means. . . . . . . . . . . . . . i Total lobbying expenditures (add lines c through h.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities. BAA Schedule A (Form 990 or 990.EZ) 2006 Yes No Amount TEEA0405L 0' /19/07 Schedule A (Form 990 or 990-EZ) 2006 Teen Esteem 20-1598494 Ba.;t,:\<<Ui:; Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See instructions) 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501 (c) of the Code (other than section 501 (c)(3) organizations) or in section 527, relating to political organizations 7 a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No (i)Cash. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51a X (ii)Other assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .......... X b Other transactions: (i)Sales or exchanges of assets with a noncharitable exempt organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b X (ii)Purchases of assets from a noncharitable exempt organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b X (iii)Rental of facilities, equipment, or other assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b X (iv)Reimbursement arrangements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b X (v)Loans or loan guarantees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b v X (vi)Performance of services or membership or fundraising solicitations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b X c Sharing of facilities, equipment, mailing lists, other assets, or paid employees. . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . c X d If the answer to any of the above is 'Yes,' complete the following schedule. Column (b) should always show the fair market value of the ~oods, other assets, or services given by the re~ortin~ or~anization. If the organization received less than fair market value in Page 7 anv ransaction or sharinq arranqement, show in co umn d) t e value of the gooas, other assets, or services received: (a) (b) (c) (d) Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangements N/A 52 a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 5277 . . . . . . . . . . . . . . . . . . . . . b If 'Yes,' complete the followin schedule: (a) Name of organization ~ 0 Yes [RJ No (b) Type of organization (c) Description of relationship N/A BAA Schedule A (Form 990 or 990-EZ) 2006 TEEA0406L 01/19/07 Schedule B (Form 990, 990-EZ, or 990-PF) Department of the Treasury Internal Revenue Service Name of organization OMS No. 1545-0047 Schedule of Contributors Supplementary Information for line 1 of Form 990, 990-EZ and 990-PF (see instructions) 2006 Teen Esteem Organization type (check one): Filers of: Form 990 Dr 990-EZ I Employer identification number 20-1598494 Section: ~501 (c)( 3 ) (enter number) organization 4947 (a) (1 ) nonexempt chantable trust not treated as a private foundation 527 political organization Forni 990.PF ~501 (c)(3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501 (c)(3) taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. (Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule - see instructions.) General Rule - o For organizations filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from anyone contributor. (Complete Parts I and II.) Special Rules - IKJ For a section 501 (c)(3) organization filing Form 990, or Form 990.EZ, that met the 33- 1 13% support test of the regulations under sections 509(a)(1)1170(b)(1)(A)(vi) and received from anyone contributor, during the year, a contribution of the greater of $5,000 or 2% of the amount on line 1 of these forms. (Complete Parts I and 11.) o For a section 501 (c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from anyone contributor, during the year, aggregate contributions or bequests of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. (Complete Parts I, II, and III.) DFor a section 501 (c)(7), (8), or (10) organization filing Form 990, or Form 990.EZ, that received from anyone contributor, during the year, some contributions for use exclusively for religious, charitable, etc, purposes, but these contributions did not aggregate to more than $1,000. (If this box is checked, enter here the total contributions that were received during the year for an exclusively religiouS,charitable, etc, purpose. Do not complete any of the Parts unless the General Rule applies to this organization because it received nonexcluslvely religious, charitable, etc, contributions of $5,000 or more during the year.) . ... ~ $ Caution: Organizations that are not covered by the General Rule and/or the Special Rules do not file Schedule B (Form 990, 990-EZ, or 990.PF) but they must check the box in the heading of their Form 990, Form 990.EZ, or on line 2 of their Form 990-PF, to certify that they do not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). BAA For Paperwork Reduction Act Notice, see the Instructions Schedule B (Form 990, 990-EZ, or 990-PF) (2006) for Form 990, Form 990-EZ, and Form 990-PF. TEEA0701L 01/18/07 . Schedule B (Form 990, 990-EZ, or 990-PF) (2006) Paqe 1 of 1 of Part I Name of organization I ;m;~~e~i~e;~i;a~on number Teen Esteem IjRai1f;\I.c,u! Contributors (See Specific Instructions.) (a) (b) (c) (d) Number Name, address, and ZIP + 4 Aggregate Type of contribution contributions . 1 ~E~~~~yt_____________________________ Person ~ - Payroll J~Y21~~~~~ag~~b~n~______________________ $ ______)L~2..9~ Noncash ~l~m~L_~~~~~I__________________________ (Complete Part II if there is a noncash contribution.) (a) (b) (c) (d) Number Name, address, and ZIP + 4 Aggregate Type of contribution contributions 2 CE~n~I~~o~~X~~~~~h5E_____________________ Person ~ - Payroll ~~~Q~~~~~ny~n~_E~~~ay___________________ $ _ _ ___ _ i>L~O..9~ Noncash ~lyeJ~~~~_~~~~~~_________~_____________ (Complete Part II if there is a noncash contribution.) (a) (b) (c) (d) Number Name, address, and ZIP + 4 Aggregate Type of contribution contributions 3 TI~~~~nEY3s~~~~~~~~I~~~_______________ Person ~ - Payroll 9~Q.O_ f~o_w_ ~a_ny~n_ B~~d_ _ _ _ ___ __ _ _ _ _ _ ___ _ _ _ __ $ _ _ _ _ _ _l..9L~O..9~ Noncash (Complete Part II if there DE~v51~~_~~2~~2________________________ is a noncash contribution.) (a) (b) (c) (d) Number Name, address, and ZIP + 4 Aggregate Type of contribution contributions 4 ~E~~E~~~~~kYY5~~_______________________ Person ~ - Payroll J_~o~~try_Q~~~~n~________________________ $ _ _ _ _ _ _ ]L~O..9~ Noncash (Complete Part II if there Al~2L~~_~~~I__________________________ is a noncash contribution.) (a) (b) (c) (d) Number Name, address, and ZIP + 4 Aggregate Type of contribution contributions 5 DEY~~~~~~~~~~~~J~P3~~________________- Person ~ - Payroll 31~~B~~1~~~~~_________________________ $ _ _ _ ___]L~O..9~ Noncash (Complete Part II if there Jl~~E~~o~LS~_~~~~______________________ is a noncash contribution.) (a) (b) (c) (d) Number Name, address, and ZIP + 4 Aggregate Type of contribution contributions - -------------------------------------- Person ~ Payroll ------------------------------------- $ ----------- Noncash (Complete Part II if there ------------------------------------- is a noncash contribution.) BAA TEEA0702L 01118/07 Schedule B (Form 990, 990.EZ, or 990-PF) (2006) Schedule B (Form 990, 990-EZ, or 990-PF) (2006) Page 1 of 1 of Part II Name of organization I ~m;~;~i~e~~i~.~on number Teen Esteem 1'3~::';"rf'II'i>'l Property (See Specific Instructions.) .:...,a/i! ::.;.:0: Noncash (a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate~ Date received Part I (see instructions ~~-------------------------------------- - ---------------------------------------- ---------------------------------------- ----------------------------------------- $ -_.--------- 1--------- (a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate~ Date received Part I (see instructions ---------------------------------------- ---------------------------------------- ---------------------------------------- ----------------------------------------- $ ----------- 1""""-------- (a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate) Date received Part I (see instructions) ---------------------------------------- ~---------------------------------------- ~---------------------------------------- ~---------------------------------------- $ ----------- 1--------- (a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate~ Date received Part I (see instructions ---------------------------------------- ~---------------------------------------- ~---------------------------------------- ~---------------------------------------- $ ----------- ~-------- (a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate) Date received Part I (see instructions) ~---------------------------------------- ~---------------------------------------- ---------------------------------------- ---------------------------------------- $ ----------- 1--------- (a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate~ Date received Part I (see instructions ~---------------------------------------- ~---------------------------------------- ---------------------------------------- ---------------------------------------- $ ----------- 1--------- BAA Schedule B (Form 990, 990-EZ, or 990-PF) (2006) TEEA0703L 01/18/07 Schedule B (Form 990, 990.EZ, or 990.PF) (2006) Page 1 of 1 of Part III Name of organization I ~;~~e~i;e~~i~a~on number Teen Esteem ~Fr'''iltillr' Exclusivelyreligious, charitable, etc, individual contributions to section 501 (c)(7) , (8), or (10) ? "a' ",Ii. .:i}l organizations aggregating more than $1,000 for the year (Complete cols (a) through (e) and the following line entry.) For organizations completing Part III, enter total of exclusively religious, charitable, etc, N/A contributions of $1,000 or less for the year. (Enter this Information once - see Instructions.). . . . . . .... , ~$ (a) (b) (c) (d) No, from Purpose of gift Use of gift Description of h.ow gift is held Part I N/A --------------------- -------------------- -------------------- -------------------- -------------------- --------------------- -------------------- -------------------- --------------------. (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee ----------------------------------- --------------------------- ---------------------------------- --------------------------. ---------------------------------- ---------------------------. (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I ~-------------------- -------------------- --------------------. --------------------- -------------------- ----------------~--_. --------------------- -------------------- --------------------. (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee ----------------------------------- ~-------------------------_. ~---------------------------------- --------------------------- ---------------------------------- --------------------------- (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I --------------------- -------------------- --------------------- --------------------- -------------------- --------------------- --------------------- -------------------- --------------------- (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee ---------------------------------- ---------------------------. ~---------------------------------- -~------------------------- ~---------------------------------- --------------------------- (a) (b) (c) (d) No. from Purpose of gift Use of gift Description of how gift is held Part I . -------------------- -------------------- --------------------. --------------------- -------------------- --------------------. --------------------- -------------------- --------------------. (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee ---------------------------------- ~-------------------------_. ----------~----------------------- --------------------------. ----------------------------------- --------------------------- BAA Schedule B (Form 990, 990-EZ, or 990.PF) (2006) TEEA0704L 01/18/07 2006 Federal Statements Page 1 Client T -ESTEEM , 0/02/07 Teen Esteem 20.1598494 03:55PM Statement 1 Form 990, Part I, Line 9 Net Income (Loss) from Special Events Less Less Net Gross Contri- Gross Direct Income Special Events Receipts butions Revenue Expenses (Loss) Banquet 69,865. 39,806. 30,059. 30,059. O. Total $ 69,865. $ 39,806. $ 30,059. $ 30,059. $ o. Statement 2 Form 990, Part II, Line 43 Other Expenses (A) (B) (C) (D) Program Management Total Services & General Fundraising Bank Fees 70. 70. Educational Events 886. 886. Insurance 2,280. 2,280. Marketing Expense 1,487. 1,487. Other Operating Expense 1,608. 1,608. Payroll Service Fee 1,667. 1,667. Professional Services 658. 658. Speaker Expense 2,732. 2,732. Workers Compensation Insurance 1,024. 1,024. Total $ 12,412. $ 10,017. $ 2,395. $ O. Statement 3 Form 990, Part IV, Line 57 Land, Buildings, and Equipment $ Total $ Accum. Basis Depree. 1,139. $ 747. $ 1,139. $ 747. $ Book Value Category Machinery and Equipment 392. 392 . Statement 4 Form 990, Part IV, Line 58 Other Assets .........."....,........, . .... ......... $ ......................... . Total $ 2,000. 1. 2,001. Deposits....... . Rounding............... .......,.,..,................,... , 6/30107 2006 Federal Book Summary Depreciation Schedule Page 1 Client T.ESTEEM Teen Esteem 20-1598494 10/02/07 03:55PM Prior Cur 1791 Date Date Cost! Bus. 1791 SDAI Current .No.. Op.c;r.riptinn Ar.qllirp.rl Snlrl R~c;ic; Pr.t SOA Op.pr Mp.thnrl .life.. Op.pr Form 199 Machinery and Equipment 1 Credit Card Machine 9/13/04 752 419 S/L 5 150 2 Office Equipment 6/22/05 300 118 S/L 5 60 3 Filing Cabinet 6/30/07 87 S/L 5 0 Total Machinery and Equipment 1,139 0 537 210 Total Depreciation 1,139 0 537 210 Grand Total Depreciation 1,139 0 537 210 r- ~ ~ = = = = = = 0.. ~ <D N N N Q) ~ Ll1 '!? jj ~ en M ca U"l 0 c.. ~ I 0 N ~ ~ ... ... ... ~ -' -' -' ..... ..... ..... (/) en en ~~ en 00 r- r- r- :;:;: m m m ... ... ... l~ c-J = r- en en en ... = 00 m m m r- M - - - ~ :::s ""C ~.~~ \ = \ =\\ =\\ Q) ",V> >'" ..c -ro <;5..... u en 9~~ = = = t: 0-'-' e Q) 0 :;:::0 = = = ~ '~ .- ~..... V> u E .20'> ::J ~r- c Q) 0-_ 0 Cl.l ro J... Cl.l a. +-' III = = = Q) IJJ C = .~ 0(3 a. Cl.l Q)Q) ~ Cl.l go e l- e \ = \ =\\ =\\ CO ~en~ =>r- '-' - - ca J... ~~ Q) ""C ~~ c-J = r- en en en Q) ~ = 00 M M m m La.. - - - to (:) (:) N 2~ 2l .". ... r- = = = ..... ..... ..... ~ c-J = N M ..... ..... ..... en <D <D ~ c Q) E Cl. .5 c cr 0 10: w :;:0 Q) '" Q) .." .u E c c Cl. :E 10: '" c e :E .5 u i::' g Cl. '" Q) Q) IJJ cr :;: E 1i) '" '" 0 w c .u IJJ "- .." Cl. c :E e ]i 0- .." 5 ~ l- e, c ~ cr '-' Cl. 0 '" '-' w '-' ~ Q) f- ........ IJ) en i::' 0 en ~ en .." IJJ ..... Q) u c ]i ]i ~ 0 . = c Q) :C en :E 0 Li: 0 0 C; - I- en '-' 0 f- f- Q - ~ ~ E '" ('t') c: 0 :;: - N M N 0 - .!!:! 0 "- ~ U 2; Teen Esteem Board of Directors Meeting January XX, 2008 Addendum A Board Resolution The board hereby approves the submission by Teen Esteem of the City of Dublin Community Group/Organization Funding Request Application for the fiscal year 2008 through 2009. The board resolves further that Linda Turnbull, Director, and Tom Mason, Chairman of the Board, are authorized and directed, in the name of and on behalf of Teen Esteem, to make, execute and deliver the application to the City of Dublin by the application due date. ACORD,.. CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIYYYY) 1/21/2008 PRODUCER (510)273-8888 FAX: (510)273-8867 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Saylor & Hill Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1939 Harrison St. #900 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland CA 94612 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: NOrrDrofi ts Insurance Teen Esteem INSURER B: P.O. Box 966 INSURER C: INSURER D: Danville CA 94526 INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. I 'UITC cH I 0"''''' , (', II ,..C I~= "DD'L TYPE OF INSURANCE POUCY NUMBER ~k'~a:;g~ Pg~fl,~rXo~N UMITS I."'..n ~ERAL UABIUTY EACH OCr.URRENCE $ 1,000,000 X jMMERCIAL GENERAL LIABILITY ~~~~~~J9E~~~nce\ $ 100,000 - ClAIMS MADE ~ OCCUR A 2007-18706-NPO 2/6/2007 2/6/2008 MED EXP 'Anv one nerson\ $ 10,000 - PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP~PAGG $ 2,000,000 ~ POLICY l::::l- ~f8r . r=f LOC ~TOMOBILE UABIUTY COMBINED SINGLE LIMIT $ 1,000,000x (Ea accident) ,-- ANY AUTO A ALl OWNED AUTOS 2007-18706-NPO 2/6/2007 2/6/2008 BODILY INJURY ,-- $ SCHEDULED AUTOS (Per person) '-- ~ HIRED AUTOS BODILY INJURY $ X NON-DWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE UABIUTY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN FA Ace $ AUTO ONLY: AGG $ EXCESS/UMBRELLA UABIUTY EACH r.'Y'URRENr.1= $ tJ OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION " $ WORKERS COMPENSATION AND I TVX~~Tf'JI\f" I OJ~- EMPLOYERS'LIABIUTY ANY PROPRIETORlPARTNERlEXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ ff yes, desaibe under SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $ A OTHER Buss. Personal Prop cw.a0005896-00-18706 2/6/2007 2/6/2008 BPP Limit $5,000 A D & 0 2007-18706 DO 2/6/2007 2/6/2008 Limi t $1,000,000 DESCRIPTION OF OPERATlONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Proof of coverage CERTIFICATE HOLDER Insured's Copy CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORaEDREPRESENTATlVE ___~'-~_s::::::" Gregg Blair/FLOR ACORD 25 (2001108) 1"~n?J:. tn1ncn na,.. @ACORD CORPORATION 1988 PDro:O" nf? STATE OF CALIFORNIA FRANCHISE TAX BOARD PO BOX 1286 RANCHO CORDOVA CA 95741-1286 In replY refer to 755:G :EMM January 24, 2006 TEEN ESTEEM 85 HIGHBRIDGE CT DANVILLE CA 94526-2620 Purpose Code Section Form of Organization Accounting Period Ending: Organization Number EDUCATIONAL 23701d Corporation June 30 2628003 You are exempt from state franchise or income tax under the section of the Revenue and Taxation Code indicated above. This decision is based on information you submitted and assumes that your present operations continue unchanged or conform to those proposed in your application. Any change in operat.ion, character, or purpose of the organization must be reported immediatelY to this office so that we may determine the effect on your exempt status. Any change of name or address must also be reported. In the event of a change in relevant statutory, administrative, judicial case law, a change in federal interpretation of federal law in cases where our opinion is based upon such an interpretation, or a change in the material facts or circumstances relating to your application upon which this opinion is based, this opinion may no longer be applicable. It is your responsibility to be aware of these changes should they occur. This paragraph constitutes written advice, other than a chief counsel ruling, within the meaning of Revenue and Taxation Code Section 21012(a) (2). You may be required to file Form 199 (Exempt Organization Annual Information Return) on or before the 15th day of the 5th month (4 1/2 months) after the close of your accounting period. Please see annual instructions with forms for requirements. You are not required to file state franchise or income tax returns unless you have income subject to the unrelated business income tax January 24, 2006 TEEN ESTEEM ENTITY ID : 2628003 Page 2 under Section 23731 of the Code. In this event, you are required to file Form 109 (Exempt Organization Business Income Tax Return) by the 15th day of the 5th month (4 1/2 months) after the close of your annual accounting period. Please note that an exemption from federal income or other taxes and other state taxes requires separate applications. A copy of this letter has been sent to the Registry of Charitable Trusts. E DIALA EXEMPT ORGANIZATIONS BUSINESS ENTITIES SECTION TELEPHONE (916) 845-4186 EO CC :DAN THOMPSON INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 DEPARTMENT OF THE TREASURY Date: DEe 222005 Employer Identification Number: 20-1598494 DLN: 17053319033005 Contact Person: DEL TRIMBLE ID# 31309 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: June 30 Public Charity Status: 170 (b) (1) (A) (vi) Form 990 Required: Yes Effective Date of Exemption: September 9, 2004 Contribution Deductibility: Yes Advance Ruling Ending Date: June 30, 2009 TEEN ESTEEM 85 HIGHBRIDGE CT DANVILLE, CA 94526 Dear Applicant: We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501 (c) (3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in. your permanent records. Organizations exempt under section 501{c) (3) of the Code are further classified as either public charities or private foundations. During your advance ruling period, you will be treated as a public charity- Your advance ruling period begins with the effective date of your exemption and ends with advance ruling ending date shown in the heading of the letter. Shortly before the end of your advance ruling period, we will send you Form 8734, Support Schedule for Advance Ruling Period. You will have 90 days after the end of your advance ruling period to return the completed form. We will then notify you, in writing, about your public charity status. Please see enclosed Information for Exempt Organizations Under Section SOl(c) (3) for some helpful information about your responsibilities as an exempt organization. Letter 1045 (DO/CG) -2- TEEN ESTEEM We have sent a copy of this letter to your representative as indicated in your power of attorney. Sincerely, ~f~ Lois G. Lerner Director, Exempt Organizations Rulings and Agreements Enclosures: Information for Organizations Exempt Under Section 501(c) (3) Statute Extension Letter 1045 (DO/CG) . Principal Tess Thomas Asst. Principal Jim Freeland www.dublin.k12.ca.us 3601 Kohnen Way Dublin, CA 94568 925-875-9376 January 23, 2008 To whom it may concern, Fallon Middle School is fortunate enough this school year to receive support services from a local non- profit group, "Teen Esteem." Teen Esteem, directed by Linda Turnbull, provides three layers of free service to Fallon students and their parents. In September 2007, Teen Esteem volunteers gave a two- day presentation to all of our eighth graders and additionally gave a two-hour informational presentation to parents prior. In October 2007, Teen Esteem arranged a parent education night at Fallon which included a panel adolescent specialists. In March 2008, Teen Esteem volunteers will be back in our classrooms once again delivering presentations to our seventh graders and their parents. Middle school can be a turbulent time for both students and parents. Adolescents experience changes socially, emotionally, and academically, like no other time in their life. Parents struggle with helping their children through this time period and need support from all angles. Students and their parents rely on the school to help support them; we rely on experienced community resources like Teen Esteem to help support our efforts to make the challenge of middle school a positive experience for all. The message that Teen Esteem gives our students is clear: the choices you make today can last a lifetime. Teen Esteem encourages our students and their parents to tackle sensitive subjects and risky behaviors through modeling effective communication skills and healthy decision-making. Educating students about the benefits and consequences of their actions; empowering them with the confidence needed to manage tough situations; and equipping them with the skills adolescents need to make good choices-that is what Teen Esteem delivers to our students. The mission is possible: adolescence can be an exciting and productive time for everyone. Having the support of Teen Esteem makes this possibility a reality. As a representative of the Fallon Middle School community, I not only appreciate their efforts, but need their support. Please feel free to contact me if you have any questions about our work with Linda Turnbull and Teen Esteem. ... Kelly Ann Zummo Counselor and Academic Dean of Students Fallon Middle School 925-875-9376 x6374 zummokelly@dublin.k12.ca.us .Joseph Ian ora Principal, 552-3013 Sylvia Ryan Vice Principal, 552-3036 Jobn McMorris Vice Principal, 552-3046 Bill Morones Vice Principal, 552-3020 John Raynor Student Services, 552-3005 San Ramon Valley High School High School Teacher Testimonial: As an educator I am constantly discouraged and disheartened by the enormous peer pressure, and the sexual behavior that exists for teens in our world today. The media bombards our student constantly and our students are constantly battling issues they don't usually have the maturity or strength to face. As a leadership teacher and high school advisor I would like to recommend the Teen Esteem assemblies to any school. Twice in the past five years San Ramon Valley School has hosted two of these school-wide assemblies. These programs speak about respect and integrity and encourage students to set the bar high; not allowing others to set the standards for them, especially in the areas of sexual and drug activity. The response has been incredibly positive and thought-provoking. The assembly easily grabs the student's attention and then has the ability to get students to think about the risky behaviors they constantly encounter and many partake in. These assemblies have been hosted for the 9th thru 12th grade and the speakers have been able to hit all the issues of dangerous behaviors at every level. Students are challenged by the message. I have seen many behaviors challenged and changed due to Teen Esteem's message. I highly recommend a Teen Esteem assembly! Sincerely, / / ,,' ."', ill!, -;'/"; f .",,/ :.',.'1 -:>'-<i /l/,' ,-"" I,.; I it I) t, i " (it.J,!n // _ /1, ;/'-"1 / ~/( l,;~/_ ~~/ ! Janet Willford Tel: (925) 552-5580 Fax: (925) 838-7802 140 Love Lane, Danville CA 94526 DUBLIN SCHOOLS VALLEYHIGH SCHOOL 6901 York Drive Duhlin, CA 94568 925-829-4322. To Whom It May Concern: Having Teen Esteem come to our campus to speak with our students has been an asset to our school climate. The volunteer speakers spoke to our students on topics such as suicide prevention, relationship issues, and drugs and alcohol use. Each volunteer spoke on topics related to their own personal story. I truly believe this is the best way to connect to our youth today. The speakers not only shared their story but truly spoke from their heart. The amazing way the Teen Esteem speakers actually communicate self-respect and integrity in all topics only reinforces to our students how to be better community citizens and raise the standards they have set for themselves. Teen Esteem helps our students to really look at these high-risk behaviors they face today and encourages them to challenge themselves to take control of their own life. As a high school counselor from Valley High School (alternative education) I would highly recommend the Teen Esteem program to all schools. JIY~ tB~ / \Yclley High School 925/829-4322 x 7907 6901 York Drive, Dublin, CA Bryce Custodio, Principal Phone: (925) 829-4322 Fax: (925) 833-7609