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<br />COPS in Schools Additional Partner Page <br /> <br />Additional Partner Information Page (If applicable) <br /> <br />This form is only required if your agency is partnering,with schools from more than one <br />school district. If your partnership involves multiple school partners, your agency must <br />provide the attached information for each school district. This form must be signed by <br />both the school official and the law enforcement executive and returned at the time <br />of application. <br /> <br />Name of Partner Agency or School District: <br />School Official Name: Title: <br />Address: <br /> <br />City: <br /> <br />Telephone: <br />Email: <br /> <br />State: <br />Fax: <br /> <br />Zip Code: <br /> <br />(Signature of School Official) <br /> <br />Date <br /> <br />(Signature of Law Enforcement Executive) <br /> <br />Date <br /> <br />43 <br />