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*This checklist is not part of the NACo contract,however,please return it with your signed contract.* <br /> *Incomplete or incorrect checklists will delay Implementation of the program* <br /> NACo Dental Discount Card Program checklist <br /> County Name/State: Date contract returned to NACo: <br /> 1.Who is the ONE contact person in the county with whom we may communicate about this program? <br /> Name and title <br /> Address(w/City,State,Zip) <br /> Phone Fax <br /> E-mail(We must have your e-mail address!) <br /> Please choose a design for your discount cards: (YOU MUST CIRCLE ONE) <br /> A.County Name(With state abbreviation) <br /> B.Logo/Seal on cards <br /> If you choose to have a logo/seal,be sure to e-mail a black and white logo/seal to agoldschmld a®naco.org. <br /> Please put("County Name—LOGO')in the subject line. <br /> 4. What is your county's current population? <br /> Will you be needing promotional materials in Spanish? <br /> 5.Please provide a street address for delivery of materials. Promotional materials will be sent via UPS <br /> Ground.NO P.O.BOXES! <br /> 6.What is your county's web address(if available)? <br /> Will this program have its own page?(Please provide) <br /> What number would county residents call to get a brochure for a card? <br /> Notes: <br /> • <br /> NACO National Association of Counties <br /> Who- <br />