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DocuSign Envelope ID:636AFD33-DA5C-4B55-88DC-03C0863BAFE3 t A - continued l <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Of the females, how many are single- <br /> female Head of Households (Omit for <br /> Human Services) 425 456 472 <br /> Ethnicity <br /> African-American 929 1,062 1,324 <br /> American Indian or Alaska Native 10 18 22 <br /> Asian 19 32 36 <br /> Caucasian 984 1,328 1,212 <br /> Native Hawaiian or other Pacific <br /> Islander 0 <br /> Other 87 102 145 <br /> Total 2,029 2,542 2,639 I <br /> Of the above, how many <br /> Hispanic/Latino 87 102 145 <br /> Of the above, how many non- <br /> Hispanic/Latino 1,942 2,440 2,494 <br /> Total 2,029 _ 2,542 2,639 <br /> Age <br /> 0-5 years <br /> 6-18 years 24 49 58 <br /> 19-50 years 1,496 1,541 1,580 <br /> 51-61 years 470 870 914 <br /> 62+ years 39 82 87 • <br /> Total 2,029 2,542 2,639 <br /> Geographic Location <br /> Durham City <br /> Durham County 21 30 32 <br /> Carrboro 624 752 778 <br /> Chapel Hill 638 764 789 <br /> Chapel Hill Public Housing Residents 32 41 <br /> Orange County 676 859 879 <br /> Raleigh <br /> Wake County 13 16 <br /> Other(Person, Chatham, Caswell, <br /> Alamance, Vance, Warren) 70 92 104 <br /> Total 2,029 2,542 2,639 <br /> Income Level —See following chart <br /> (Omit for HS) <br /> <30%Area Median Income 1,055 1,390 1,429 <br /> 31-50%Area Median Income 742 891 932 <br /> 51-80%Area Median Income 163 179 170 <br /> > 80%Area Median Income 69 82 108 <br /> Total 2,029 _ 2,542 2,639 <br /> Special Needs (Omit for HS) <br /> Elderly(Over 62) 39 82 87 <br /> Disabled (not elderly) 49 63 72 <br /> Main Application 1/25/2016 4:55:19 PM Page 'VI of 24 <br />