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CONNECT Consortium Appointments <br />Name of Organization: Cabarrus County Date of Appointments: <br />Consortium Progrom Forum (Senior Staff): <br />Primary Appointee: <br />Last Name First Name Title E -mail Phone Address City Zip <br />!d Alternate(s): <br />Last Name First Name Title E -mail Phone Address City Zip <br />Consortium Policy Forum (Elected Official): <br />Primary Appointee: <br />Last Name First Name Title E -mail Phone Address City Zip <br />!d Alternate(s): <br />Last Name First Name Title E -mail Phone Address City Zip <br />Please return ONE ORIGINAL of your SIGNED Consortium Agreement and this form to Ms. Barbie Blackwell, Centralina Council of Governments, <br />525 North Tryon Street, 12 Floor, Charlotte, NC 28202. You may also supply a PDF of this form to bblackwell@centralina.ore, or contact Ms. <br />Blackwell at 704 - 348 -2728 if you have any questions. <br />G -2 Page 314 <br />