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Please answer questions 1 -8.
Name of Program and School

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* 1. Name of Program and School

Which age group does this program component serve?

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* 2. Which age group does this program component serve?

If your program serves older and younger youth, do the older youth have special responsibilities?
Please explain.

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* 3. If your program serves older and younger youth, do the older youth have special responsibilities?
Please explain.

Contact person and email address

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* 4. Contact person and email address

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