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Name of Program <br /> <br />County's Federal I.D. Number 566000281E <br /> <br />Sponsoring Agency Juvenile Services Division <br /> <br />19A District Court Counselors <br /> <br /> DIVISION OF YOUTH SERVICES - CBA <br /> <br /> PROGRAM AGREEMENT <br /> <br />Cabarmas C~xmty Juvenile Services Restitution Program <br /> <br />Contact Person (name & address) <br /> <br />Wesley B. Seamon, Chief Court Counselor <br /> <br />P.O. Box 70, Concord~NC Zip 28026-0070 <br /> <br />Phone# 704). 786-5611 Fax #( ). <br /> <br />Referral Sources Judges and Court Counselors <br /> <br />County <br /> <br /> CABARRU$ <br />Program Type <br /> <br /> Restitution <br /> <br />Funding Period <br /> <br /> 1/1/98 thm <br /> <br />CBA Assigned I.D. # <br /> <br />6/30/99 <br /> <br />New Program X <br />Continuation <br /> <br />*Client Capacity 12 . Anticipated average length of stay 90 <br /> <br /> Estimated number of youth to be served during funding period 24 <br /> <br />(days). <br /> <br />*Actual number of youth admitted last fiscal year: <br /> <br /> Reported using Client Tracking Forms <br /> <br /> Reported using Annual Program Review <br /> <br /> # Juvenile Court or law enforcement referred <br /> <br />Date received in Regional Office <br /> <br />Please submit 4 Copies with original signatures. <br /> <br />*If the funds being requested will be used for more than one program component please provide this information for each <br />component on a separate sheet. <br /> <br />DYS (REV. 10-95) <br /> <br /> <br />