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Portland House Bangor House Date: (PLEASE PRINT CLEARLY)Name: Address: City, State, Zip: Primary Phone: Secondary Phone: Home Cell Work Home Cell Work Birth date: / / Email Address: EmploymentStudents

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Apply for a service refers to the process of formally requesting a specific service from an organization or governmental authority.

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The purpose of applying for a service is to initiate the request for that service and provide the necessary information for processing.

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Typically, personal identification information, service details requested, and any relevant documentation must be reported on the application.

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