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MEMORANDUM OF UNDERSTANDING <br />CONTACT INFORMATION <br />All contact information is kept confidential, unless checked off for permission to be <br />made available for public use (e.g. website) . Please write legibly in print format to <br />ensure accuracy. <br />Organization /Agency <br />::5an4c� Ado- (0o 1,'c QgpQr4ry?crf <br />Law Enforcement <br />Victim Service Provider <br />School <br />Community Group <br />First Name <br />Last Name <br />Title lge,/7/) <br />Business Phone Number <br />Faith -based Organization <br />Non - profit Organization <br />Government <br />Other: <br />714— 215 -- fe) O / <br />Address 6�O �- i/- "C, reyJ 7,�e/- 1:11 <br />City <br />—5 a,�Il % At 0 Zip Code 612-/ 6 2- <br />Email C:d"CJ /6 5aof"GZ-ae2a.6 <br />V <br />I am signing on behalf of my organization /agency. <br />I am signing on behalf of myself. <br />Yes, I agree to have my contact information released to the public. <br />No, I don't agree to have my contact information released to the public. <br />Comments /Requests: <br />