Social Work Program Agency Affiliation Agreement Page 6

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IN WITNESS WHEREOF the parties hereto have caused this Agreement to be executed by
their respective authorized officers as of the day, month, and year as stated in the first paragraph
of this Agreement.
AGENCY:
By:
Agency Chief Executive Officer
Date:
TEXAS A&M UNIVERSITY-KINGSVILLE:
By:
Provost, Texas A&M University-Kingsville
Date:
By:
Dean, College of Arts and Sciences
Date:
By:
Director, Social Work Program
Date:
By:
Social Work Field Education Coordinator
Date:

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