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ESGP Round 4 Application Check List <br /> Name of Local Government (applicant) : County of Orange <br /> Name of Subrecipient: Inter-Faith Council Community Shelter <br /> x 1. Do you have one original and one copy of the following <br /> forms for each Shelter? <br /> x a. Application Summary Form <br /> x b. Community Needs Form <br /> c. One six page Operations/Services Activities Form <br /> OR <br /> x d. One four-page Rehabilitation Activities Form or both. <br /> x e. Certification Form <br /> • <br /> x f. If applicable, is the comment letter from the Division <br /> • of Archives and History enclosed? <br /> 2. Is the original application signed in ink by the local government <br /> , Chief Elected Officer on the Applications Summary Form and on the <br /> Certification Form? (Signature must match typed name) . <br /> x 3. Are all questions of the application package answered completely? • <br /> x 4. Will all application materials be received by the Division of <br /> Community Assistance on March 28, 1989, or be postmarked.by this date? <br /> N/A 5. If applicable, will'both the: Certification Form•; FSGP-'#104-and:the :7104 _... <br /> signature on the Application=Stmmary-Form,_ESGP:41.01•be••received-or- <br /> postmarked on or before-April:11; 1989? __,-_: r : , . <br /> March 21, 1989 <br /> Signature Date <br /> Local Government Contact Person • <br /> (Should •be same as on Application Summary Form) - • <br /> • <br /> • <br /> • <br /> • <br />