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DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357 t A - continued <br /> Provider's Outside Agency Application <br /> Florence Gray Soltys Adult Day Health Program <br /> ("Operated 6y. Sem;ar Care of Orange Coemty, //7c) <br /> 705 fileadowland Drive <br /> Hillsborough, North Carolina 27278' <br /> • 1/ammona; Pres/de <br /> • ESperse,7 President <br /> eailferson, Treasurer <br /> Karen Daniet Secretary <br /> TeA (979)21'5,2077 <br /> Far(9W)2.95-2078' <br /> Main Application: Program/Project Description <br /> i. Other pertinent information included: <br /> Please see attached forms: <br /> • 2 page document on "North Carolina is Aging" <br /> • 2 program brochures <br /> • Caregiver's Corner Quarterly Newsletter <br />