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<br />COPS In Schools - Additional PaMnor Pago <br />(Fo be used if there is more than one partnering agency) <br /> <br />Please use this form if you are applying for funding under the COPS in Schools grant program and are <br />partoering with more than one school or school district. As a reminder, you must designate one school <br />official as the school representative under this grant program. However, you may partner with <br />numerous schools or school districts. If you are partnering with more than one school or school district you <br />must provide the following information for each school or school district. This form must be signed by both <br />the law enforcement executive and the school official and returned at the time of application. <br /> <br />Name of Additional Partner Agency or School District: <br /> <br />School Official Name: <br />._._..... -* <br />Address: <br />City: <br />State: <br />Phone: <br /> <br />Title: <br /> <br />" <br /> <br />Zip Code: <br />Fax: <br /> <br />Law Enforcement Executive's Signature: <br /> <br />Date: <br /> <br />(signature of the official named in Section II of this application) <br /> <br />School Official's Signature: <br /> <br />Date: <br /> <br />(signature o/person named in Section /II under Partner Information) <br /> <br />, ,oJuuJ 4,,,,/ :1/ ."IJ/J/J <br />c(' \:..r..J~ <br /> <br />II COPS b1 Schools <br /> <br />App/icatkJn Form <br /> <br />c:J <br />