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Are you available for evening meetings? <br />References: <br />Name: Phone: <br />Relationship to you: <br />Name: Phone: <br />Relationship to you: <br />Applicant Signature: <br />Parent /Guardian Signature: <br />Please return this application in person or via mail to: <br />Heather Jones <br />Cabarrus County 4 -H <br />715 Cabarrus Ave. West <br />Concord, NC 28027 <br />(704)920 -3310 — fax <br />hrjones @cabarruscounty.us <br />'* ti -z- <br />= . k rrrc'RO , ✓ <br />11/2010 <br />Attachment number 2 <br />Page 152 <br />G -4 <br />- Empowering People• Pimping Solutions <br />