Contract # FY 17 HA Division of Family Development Annex A -Service Delivery Information Program Name: Site Address: City, State, and Zip Site Phone Number: Program Director/Coordinator Telephone #: Fax: E-Mail: Service will be provided as follows (designate time): From To Sunday Monday Tuesday Wednesday Thursday Friday Saturday Services will not be provided on the following occasions: # Holidays _______ Date (s) Occasion Emergency Provisions: Describe any special arrangements which have been made to handle emergencies, e.g. voice mail instructions, special telephone numbers etc.:_________________________________________________
FY 17 HA Contract # Division of Family Development Annex A -Service Delivery Information Program Name: Site Address: City, State, and Zip Site Phone Number: Program Director/Coordinator Telephone #: Fax: E-Mail: Service will be provided as follows (designate time): From To Sunday Monday Tuesday Wednesday Thursday Friday Saturday Services will not be provided on the following occasions: # Holidays _______ Date (s) Occasion Emergency Provisions: Describe any special arrangements which have been made to handle emergencies, e.g. voice mail instructions, special telephone numbers etc.:_________________________________________________
fy17_ha_county_renew.docx