Application Contents. Each application for a permit shall contain the information specified in WAC 000-00-000.
Application Contents. Each Application shall contain the following information:
Application Contents. In addition to contents required by law, the renewal application may include comments and additional information provided by the School about its progress toward meeting the District’s accreditation indicators. The format of the renewal application is provided in District policy LBD*-R – Relations with District Charter Schools (Procedures for Establishment, Review, Renewal, Revocation and Closure).
Application Contents. 5.1. The application shall include, but may not be limited to:
Application Contents. The Technical Services Contract application must consist of the following: • Applicant Contact Information • Project Type and Description • Letters of Commitment • Designated Official All applications must be submitted through the online application portal. Appendix B notes the full information required through the online application form, but is not intended for submission by an applicant.
Application Contents a. An application for a Development Agreement shall include a proposed Development Agreement that shall, at a minimum, include all of the following:
Application Contents. Please Check Application Checklist (Document A) Grantee Information Form (Document B) Narrative Summary Form (Document C) Governmental Payee Form CDPH 9083 (Document D) Grant Activities and Reporting/Tracking Measures (Exhibit A) Grantee Information Form Organization This is the information that will appear in your grant agreement. Federal Tax ID # 00-0000000 Name Alameda County Public Health Department Mailing Address 0000 Xxx Xxxxxxx Xxxx., Xxx Xxxxxxx, XX 00000 Street Address (If Different) (same) County Alameda Phone (000) 000-0000 Fax (000) 000-0000 Website xxx.xxxxx.xxx Grant Signatory The Grant Signatory has authority to sign the grant agreement cover. Name Xxxxx Xxxxxx Title President, Alameda County Board of Supervisors If address(es) are the same as the organization above, check this box and go to Phone Mailing Address 0000 Xxx Xxxxxx, Xxxxx 000, Xxxxxxx, XX 00000 Street Address (If Different) Phone (000) 000-0000 (000) 000-0000 assistant Email Xxxxxxxxxx.Xxxxxx@xxxxx.xxx Project Director The Project Director is responsible for all of the day-to-day activities of project implementation and for seeing that all grant requirements are met. This person will be in contact with Oral Health Program staff, receive all programmatic, budgetary, and accounting mail for the project and be responsible for the proper dissemination of program information. Name Xxxxxxx XxXxxxxxx Title LOHP Project Director If address(es) are the same as the organization above, check this box and go to Phone Mailing Address 0000 Xxx Xxxxxxx Xxxx., Xxx Xxxxxxx, XX 00000 Street Address (If Different) (same) Phone (000) 000-0000 Fax (000) 000-0000 Email Xxxxxxx.XxXxxxxxx@xxxxx.xxx Funding These are the annual Funding amounts your LHJ will accept for grant purposes. Total Funding Requested $406,713 Narrative Summary Form Alameda County Public Health Department Alameda County experiences a well-documented epidemic of dental disease that disproportionately affects communities of color and low-income residents. In past decades, the health and well-being of county residents have improved; however, profound disparities by race and ethnicity persist, including in our residents’ dental health. Nearly one in three (32.8%) children 0-5 years of age screened at selected Women, Infants and Children (WIC) clinics in Alameda County showed evidence of untreated dental decay (2016). Among students screened through the Oakland Student Smiles program, 45% of students had untreated tooth decay with 15...
Application Contents. Applications for a large family day care permit shall be filed with the director and shall be accompanied by the following:
