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<br />EXHIBIT 10 <br /> <br />Capital Area Planning Council <br />9-1-1 Public Education Materials <br />ORDER FORM <br /> <br />Agency/Organization Name: <br /> <br />Contact Person: <br /> <br />Mailing Address: <br /> <br />Street/P.O. Box <br /> <br />City <br /> <br />State <br /> <br />Zip <br /> <br />Phone: ( <br /> <br />) <br /> <br />Date: <br /> <br />CAPCO Staff Authorization: <br /> <br />Explain for what use: <br /> <br />Please write in the amount of needed materials in the blanks below. <br /> <br />Public Education orders will be filled as closely as possible as they are requested. Some items may not be available in large quantities at all times <br />throughout the year. Put down what you need and we'll do our best to acco~odate your agency/organization. <br /> <br />Received by: <br /> <br />Date: <br /> <br />For CAPCO use only <br /> <br />Date ordered filled: <br />Delivery/Pickup Instructions: <br /> <br />o mail 0 deliver 0 pickup <br /> <br />Date <br /> <br />Initial: <br /> <br />October/99 <br />