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I)IV[S1ON OF YOU'Itl SERVlCES- CBA <br /> PRO'GRAM AGrEEmeNT <br /> <br /> Name of Program Ilome-Based Services <br /> / <br /> Sponsoring Agency Cabarrus County Department / County <br /> / <br /> o£ Social Services ! Cebarrus <br /> / <br /> Contact Person (same & address) / Program Type <br /> / <br /> Rod Duncan, Social Work Pro~[am Manager / Non-Residential <br /> / <br /> P, O. Box 668, Concord, N.C. / Punding Period <br /> / <br /> 28026-0fi68 Phone 786-7141 / 7/1/90 thru 6/30/91 <br /> Concord, N. C. 28026-0668 <br /> <br /> / <br /> Referral Sources District Court Judges, ! Z[3005 <br /> / <br /> Juvenile Court Counselors, Farents/Caretakers / New Program <br /> / <br /> School Personnel, Department of Social Services / Continuation X <br /> <br />* Client Capacit~ lO . Anticipated average length of stay 120 <br />(days). Estimated number of youth Co be served during funding period <br /> <br /> 30 <br /> <br /> Date received in regional office <br /> Date received in central office <br /> Date of CBA Approval <br /> <br /> Please submit 4 copies with original si~j?tures. <br /> <br />*If the funds b'eing r~quested will be used for more than one program component <br /> <br />DYS (Rev. 1/87) <br /> <br /> <br />