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Are you available for evening meetings? <br />References: <br />Name: <br />Phone: <br />Relationship to you: <br />Name: <br />Relationship to you: <br />Applicant Signature: <br />Parent /Guardian Signature: <br />Please return this application in person or via mail to: <br />Megan Smit <br />Clerk to the Board <br />Cabarrus County <br />P.O. Box 707 <br />Concord, NC 28026 -0707 <br />Fax: 704 - 920 -2820 <br />mismit @cabarruscounty.us <br />NC State tfowarsily <br />1111 1w, Uni�:mq <br />COOMRATM <br />EXTENSION <br />10/2012 <br />Attachment number 5 <br />1 -6 Page 76 <br />Phone: <br />Date: <br />