HomeMy WebLinkAboutItem 8.1 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
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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
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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
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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.
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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.
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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.
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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,
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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. "
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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. "
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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.
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f. Specify numbers of clients served by agency, then by PROPOSED
PROJECTIPROGRAM:
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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.
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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.
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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
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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.
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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
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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
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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:
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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.
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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:
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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:
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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
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$
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(aX1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
Department of the Treasury
Internal Revenue Service ~ The organization may have to use a copy of this return to satisfy state reporting requirements.
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
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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