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DIVISION OF YOUTH SERVICES - CBA <br /> PROGRAM AGREEMENT <br /> <br />Name of Program Ho~e-Based Services <br /> <br />Sponsoring Agency Cabarrus County Department <br /> of Social Services <br /> <br />! <br />/ County <br />/ <br />/ Cabarrus <br /> <br />Contact Person (name & address) <br /> <br /> Rod Duncan, Social Work Program Manaser <br /> <br />P. O. Box 668, Concord, N. C. <br /> <br />28026-0668 Phone 786-7141 <br />Concord, N. C. 28026-0668 <br /> <br />Referral Sources District Court Judges, <br /> <br /> Juvenile Court Counselors, Parents/Caretakers, <br /> <br />School Personnel, Department of Social Services <br /> <br />/ <br />/ Program Type <br />/ <br />/ Non-Residential <br />/ <br />/ Funding Period <br />/ <br />/ 7/1/92 thru 6/30/93 <br />/ <br />/ CBA Assigned I.D. # <br />/ <br />/ 213005 <br />/ <br />/ New Program <br />/ <br />/ Continuation X <br /> <br />* Client Capacity <br /> <br />(days). <br /> <br /> 3O <br /> <br /> 10 Anticipated average length of stay 120 <br /> <br />Estimated number Of youth to be served during funding period <br /> <br />Date received in regional office <br /> <br />Date received in central office <br /> <br />Date of CBA Approval <br /> <br /> Please submit 4 copies with ori$inal sisnatures. <br /> <br />*If the funds being requested will be used for more than one program component <br />please provide this information for each component on a separate sheet. <br /> <br />DYS (Rev. 1/87) <br /> <br /> <br />