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APPLICATION <br />I. Organization Data <br />Name of Applicant Organization - North Suburban Consumer Advocates for the <br />Handicapped, Inc. (NSCAH Inc.) <br />Address - 1201 89th Avenue NE Suite 345 <br />City - Blaine, MN County - Anoka ZIP - 55434 <br />Tax Status - 501 (c) 3 Non-profit <br />Fiscal Officer - Anoka County Community Action Program <br />Telephone - 783-4708 <br />Authorized Official - Sue Dennistoun <br />Primary Contact Person - Jesse J. Ellingworth <br />Address - Office of NSCAH or 1800 111th Ave. Apt 137 <br />Telephone - 783-4708 (work) or 757-7603 (home) <br />City - Coon Rapids, MN <br />County - Anoka Zip - 55433 <br />