Effective Date and Signatures: This agreement is effective on the date signed by all parties and valid from October 1, 2013 to September 30, 2014. Authorized signature: SNAP-Ed Contractor Authorized signature: Partner Printed Name: Printed Name: Date: Date: List the sites and location where Party A will provide SNAP-Ed for Party B in the following table. (i.e. If a school district is Party B, list all schools where SNAP-Ed intervention(s) will be conducted by Party A.) Partner Locations Location Name Address, City, Zip For people with disabilities, this document is available on request in other formats. To submit a request, please call 1-800-525-0127 (TDD/TTY call 711). DOH 940-015 March 2013
Effective Date and Signatures: This agreement is effective on the date signed by all parties and valid from October 1, 2013 to September 30, 2014. Authorized signature: SNAP-Ed Contractor Authorized signature: Partner Printed Name: Printed Name: Date: Date: List the sites and location where Party A will provide SNAP-Ed for Party B in the following table. (i.e. If a school district is Party B, list all schools where SNAP-Ed intervention(s) will be conducted by Party A.) Partner Locations Location Name Address, City, Zip For people with disabilities, this document is available on request in other formats. To submit a request, please call 1-800-525-0127 (TDD/TTY call 711). DOH 940-015 March 2013
940-015-PartAgreeFY14.docx