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DocuSign Envelope ID: 1BE60CB8-ODEB-4A6C-BF4E-E85200702589 <br /> 011 <br /> ANGE COUNTY <br /> NORTH CAROLINA <br /> FY 2020-21 Outside Agency <br /> Contact Information <br /> Congratulations on being awarded Outside Agency Funding for FY 2020-21! <br /> Please provide the below information regarding your agencies' contacts for fiscal year 21. <br /> Please complete and sign this form electronically and submit to Allen Coleman at <br /> outsideajtencies@oraneecountync.eov by Friday,August 14 2020. <br /> Section A-. Agency Information: <br /> Agency Legal Name Reentry House Plus, Inc. <br /> Agency DBA (IfApplicahle) <br /> Physical Address Not disclosed (privacy) <br /> Mailing Address PO Box 361 , Hillsborough, 27278 <br /> Agency's Telephone Number 773-671 -6887 <br /> Agency Website www.reentryhouseplus.wildapricot.org <br /> Section B. Executive Director's Information <br /> Executive Director's Name David Stanford, Secretary <br /> Executive Director's Telephone Number 773_671 -6887 <br /> Executive Director's Email Address reentryhouseplus@yahoo.com <br /> Will the Executive Director Sign the YES ® NO <br /> Performance Agreement? <br /> If no, please tell us who?—Name: <br /> Email Address dstanford4900@yahoo.com <br /> 2] Application Orientation & <br /> What type of Communications should this Training Opportunities <br /> individual receive? II Financial Reporting <br /> Please select check all that apply: El Performance Reporting <br /> ED Performance Agreement Execution <br /> 1 <br />