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OFFICE OF JUVENILE JUSTICE <br />JUVENILE CRIME PREVENTION COUNCIL - JCPC <br />PROGRAM AGREEMENT <br /> <br />Name of Program Ps~.'chological Services to Juvuile Court <br /> <br />Sponsoring Agency Piedmont Behavioral Healthcare <br /> <br />Program Manager (name & address) <br />Vincent L. Pastore, Ph.D. <br />1305 South Cannon Bird <br /> <br />Kannapolis. NC <br /> <br /> Zip 28115 <br /> <br />Phone# (704) 939-1100 Fax# <br /> (704) <br />Program Fiscal Officer (name & address) <br />Ann Wilson <br /> <br />939-1120 <br /> <br />245 LePhillipeCt, NE <br />Concord, NC 28025 <br /> <br />Phone# (704) 721-7000 Fax, g 704-721- <br /> 7010 <br /> <br />Referral Sources <br /> <br />19'h Judicial District; Juvenile Court: <br />Counseling Services <br /> <br />County: Cabarms <br /> <br />Program Type: Psychological <br />Services <br /> <br />Funding Period <br />7/1/99 thm <br />OJJ Assigned <br /> <br />6/30/2000 <br /> <br />New Program <br /> <br />Continuation XX <br /> <br />Formula Grant <br /> <br />*Client Capacity 28-32 . Anticipated average length of stay <br /> <br />Estimated number of youth to be served during funding period 80-96 <br /> <br /> *Actual number of youth admitted last fiscal year: <br /> Reported using Client Tracking Forms or Annual Program Review: <br /> <br /> 42 # Juvenile Court referred 81 % <br /> <br /> 0 # Law enforcement referred 0 % <br /> * As of 2/23/99 <br /> <br />Date received in Regional Office <br /> <br />90-120 <br /> <br />52* <br /> <br />(days). <br /> <br />Please submit 4 copies with original signatures <br /> <br />*If the funds being requested will be used for more than one progrmn component please provide this information <br /> <br /> <br />