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orientation, creed, place of birth , or disability; 2. That it will abide by all relevant local, state and federal laws and <br />regulations and; 3. That it has read the information contained in the Instructions on pages 1 and 2 and understands and <br />will comply with all provisions thereof. <br />Certified by:* <br />Name* Molly Jones <br />Applicant's Title* Executive Director