Appendix D: Partnership Program Focus Group Acknowledgement of Receipt of Payment
I acknowledge receipt of the $50 payment for participating in the Partnership Program Focus Group in [city, state] on [date]
Name, printed Signature
OMB Control Number: 0607-XXXX
Expiration Date: September 30, 2011
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | ICFI |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |