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ATTACHMENT HMENT"A" FY 2005)--page <br /> B. COUNCEL ON AGING MEMBERS of application film date). Please <br /> lit names and titles, <br /> begl='ng with the chair of the C A. <br /> Arthur ween tei , Chairperson <br /> Regina Godfrey, Treasurer <br /> Leila Botsford <br /> MariJo Dorney, Secretary <br /> dam Mule <br /> Please note the chair's home mailing address. Thank you. <br /> l Falmouth Road -104, l ashpee,IIA 02649 <br /> C. APPLICANT SIG ATrCJ The persons whose signatures appear below are authorized to commit the <br /> applicant to this application for state grant funding and hereby agree to its submission to the Executive <br /> Office of Elder Affairs. <br /> EDEA reserves the right to modify the purposes and/or proposed expenditures of this application prior to <br /> execution of th6 final grant agreement. The amount of this award may be modified subject to <br /> appropriation by the General Court. <br /> lamcsLQnn -J/-J <br /> (PRINT)Director/Coordinator i n tur (date) <br /> Y. <br /> (PRINT) Chairperson (Signature) (date) <br /> F r 1J *y <br /> -hy <br /> (PRINT/NOTE) Chair,-Board of Selectmen; si natUe- date) �; a c '� <br /> Town Manager/Administrator; � <br /> Executive Secretary Ad -dWstrator; Mayor; � �" <br />