Transcription of DEPARTMENT OF PUBLIC SOCIAL SERVICES
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VP AAF-27 (REV. 07/2017) SPONSOR INFORMATION Please complete the following (please print clearly): Individual Company/Organization Group _____ Last Name First Name Middle Initial Address:_____ Street City Zip Code Contact Person (Group/Organization Only): _ Last First Telephone Number: ( ) _____ Fax Number: ( ) _____ E-Mail: _____ How did you hear about the Program?_____ 1. Would like to sponsor a family that resides in: (indicate desired geographic location) San Gabriel Valley East Los Angeles West Los Angeles Central LA-Hollywood Pomona Valley San Fernando Valley Lancaster-Canyon Country South Los Angeles South Bay-Long Beach Southeast County ( South Gate, Norwalk, Commerce) Pasadena, Glendale, Burbank NO preference, would like to donate where most needed.
VP AAF-27 (REV. 07/2017) SPONSOR INFORMATION Please complete the following (please print clearly): If County employee, please indicate Department/Division/Section:
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CALIFORNIA – HEALTH AND HUMAN SERVICES, CALIFORNIA DEPARTMENT OF SOCIAL SERVICES, Social Services, DEPARTMENT OF PUBLIC SOCIAL SERVICES OPEN, DEPARTMENT OF PUBLIC SOCIAL SERVICES OPEN COMPETITIVE, Medical genetic services in developing countries, Social, Virginia, Application for Benefits, Social Services and Well-being, SERVICES, Social Determinants of Health