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DIVISION OF SOCIAL SERVICES - - <br />COMMUNITY CHILD PROTECTION TEAM GRANT APPLICATION . · <br /> FACE SHEET <br /> <br />NAME OF APPLYING AGENCY'OR ORGANIZATION: C~;ah:arr,,,:: O~mm,~nA+y Ch {'id <br /> Protection Team <br />ADDRESS: c/o Cab. DSS, 1303 S. Cannon Blvd. Kannapolis, NC 28083 <br /> <br />COUNTY:. <br /> <br />CCPT CHAIRPERSON Anne S. Laukaitis <br /> <br />GRANTC6NTACT PERSON: Anne Laukaitis <br /> <br />TELEPHONE# 70a / 7aa / 40n7 <br /> <br />ADDRESS: 1tip r.~k~, c, cmo,-~w~ n~ <br /> <br />TOTAL FUNDS REQUESTED: <br /> <br />AUTHORIZATION <br /> <br /> TITLE: CCPT Chair <br /> FAX#: 70a / 7n6 / 1034 <br /> <br />$50r 000. FEDERAL TAX ID #: 56-6000281 <br /> <br />We, the undersigned, have read and understand the requirements contained in the grant and hereby make <br />application for the funds. All expenditures shall be in compliance with grant requirements. <br /> <br />Chalrp~.S ~auka i t i s <br /> l_.~Tames F. Cook V <br /> <br />Date <br /> <br />Date <br /> <br />Board of County Commissioner Member <br /> <br />Date <br /> <br />The signature of at least eight CCPT Members is required. By signing this document the CCPT member <br />acknowledges participation in the development of the CCPT project for which funds are being applied. <br /> <br />Please complete this page as presented. This will be page one of the application packet. Submit the original <br />and one {1) copies of the grant application packet using this format: I. Face Sheet, II Application for CCPT <br />grant form, ill Statement of Need, IV. Program Description, V. Community Support, VI. Plan of Action and <br />VII. Program Budget. Please use staples to bind each package to~;ether. <br /> <br /> <br />