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Orga►vation:Crossover Mission Inc. <br /> Program:Basketball and Academic Mentorship Program <br /> Funder.Children's Services Advisory Committee <br /> If these funds are being used to match another source,name the source and the $ amount: <br /> The Organization's Board of Directors has approved this application on(date). <br /> /�lU/�/NC cT�ull�/fl>r�S f 1. <br /> Name of President/Chair of the Board Signa re <br /> Name of ecutive Director/CPO Signature <br /> I <br />