1991 AGN MAY 28 I18 - Laserfiche WebLink

Browse Search

-California D lent of Education Chiid Development Division CD�-3704 (Rev. 9/90) Send three copies with original signatures by December 19, 19% To: Child Development Division Attention: Lucy Rhodes 560 J Street, Suite 220 Sacramento, CA 95814 Instructions for completing this form and other helpful information are included in the accompanying REPORTER 90-31. Read the statements, and select Statement A OR Statement B, as appropriate. The signature of an authorizcd agent is required. CERTIFICATION OF APPLICATION INFORMATION FOR FISCAL YEAR 1991-92 For continued funding to provide child development services in fiscal year 1991-92, I certify as the authorized agent, that all applicable state and federal statutes and regulations will be observed. I also certify to the following statement. [ xx ] Statement A. The information contained in the most recent application submitted to the Child Development Division is correct and complete. [ ] Statement B. Except for the modifications indicated on the attached program narrative and/or legal status change page(s), the information contained in the remaining pages of our most recent application submitted to the Child Development Division is correct and complete. Project Number: (See enclosed Site Information sheet for correct.project number.) 3 6 1-1 H 1 2 9 0 0 IJ 0 3 8 Legal Name of Agency CITY OF COLTON $111,837 Address City Zip Code 650 N. LaCadena Dr. Colton CA 92324 Executive Officer/Superintendent Telephone Robert Wynn (714)370-5086 Address 660 Colton Avenue Colton CA 92324 Program Director Telephone Susan Brigham (714) 370-5086 Address 660 Colton Avenue Colton CA 92324 Board Chairperson Telephone Edmund Sotelo 614) 370-5051 Address 650 N. LaCadena Dr. Colton CA 92324 SIGNATURE OF AUTHORIZED T DATE - 12-3-90 Name and Title of Authorized Agent Rohert Wynn, Executive Officer, Director, Parks,'Recreation & Hum.Sv