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FY'93 <br />SENIOR CENTER OUTREACH SERVICES PROPOSAL TO <br />CENTRALINA AREA AGENCY ON AGING <br /> CENTRALINA COUNCIL OF GOVERNNRNTS <br /> <br />PART A. APPLICANT INFORMATION <br />1. Agency Name and Address <br /> <br />Cabarrus County Dept. of Aging <br /> <br />331Corban Avenue, S. E. <br />Concord, N.C. 28026 <br /> <br />2e <br /> <br />3. <br /> <br />4. <br /> <br />5. <br /> <br />Telephone 704-788-9899 <br /> <br />Agency Director. Eleanor Koski <br /> <br />Program Director. <br /> <br />Board Chairman Name and Address <br /> <br />Carolyn Carpenter <br /> <br />Se <br /> <br />e <br /> <br />Type of Agency: Private Non-Profit * <br /> <br />Private For-Profit <br /> <br />Public. x <br /> <br />*If the Agency is private non-profit, attach a listing <br />immediately behind Part A of all Board members and indicate <br />if each member is either minority, female or handicapped. <br /> <br />Federal Funds Requested (90% of Budget) $ 2,289 <br /> <br />Local Match (10% of Budget) <br /> <br />$, 254 <br /> <br />Total Budget <br /> <br />$. 2,543 <br /> <br />As the authorized signatory official, I hereby certify that <br />the named Agency is duly approved to submit this application <br />requesting funding to provide the service(s) specified in <br />keeping with the provisions of Parts A, B and C of this <br />application and the Service Standards issued by the North <br />Carolina Division of Aging. <br /> <br />Authorized Signatures: <br /> <br />Agency Director <br /> <br />County Manager/ <br />Board Chai£man <br /> <br />(Signature) <br /> <br />(Signature) <br /> <br />Date <br /> <br />Date <br /> <br /> <br />