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F ~ <br /> f+ <br /> Formal Petition <br /> Page 3 <br /> This petition must be signed, dated and returned by the close of <br /> business November 24, 1987 to the following address: <br /> • <br /> Mr. Joel C. New, Director <br /> Division of Employment and Training . <br /> • <br /> P. 0. Box 276B7 <br /> Raleigh," North Carolina 27611 <br /> In accordance with Section 628.1(b) of the U. S. Department of Labor <br /> regulations for programs under the Job Training Partnership Act, this <br /> Formal Petition form must be used for requests for_sesvice delivery area <br /> designation. <br /> To assist in the timely completion of tasks associated with the <br /> implementation of the local JTPA program, we request that you provide the <br /> following information. The implementing agency(ies) indicated below may <br /> or may not be the same agency(ies) selected by the PIC and CE0 to <br /> administer the JTPA program once the SDA is established. The use of an <br /> implementing agency allows DET to address information to a single point. . <br /> 1. Administrative Entity: Agency Name TO BE DETERMINED BY TNF, SmjTF <br /> Address <br /> Contact Person <br /> (Typed Name) (Title) <br /> Telephone Number ( ) <br /> 2. Grant Recipient: Agency Name ORAN • j. <br /> 106 EAST MARGARET LANE <br /> Address EILLSBOB0fCP. N.C. . 2727P <br /> Contact Person pL3 m -T Fr,T;_ INTERIM MANAGER <br /> mo <br /> (^ d v.Name) <br /> aelephone Number ( 919 ) 732-8181 <br /> 3. Agency Responsible for Private Industry Council development and <br /> appointments: <br /> Agency Name TO BE DETERMINED BY THE STATE <br /> • <br /> Address <br /> Contact Person <br /> (Typed Dame) (Title) <br /> Telephone Number ( ) . <br />