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DocuSign Envelope ID: 373C6CF5-BA35-4F9B-A420-087EBFE4784E t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Innovations are age appropriate, evidence- based, and occur mostly in the home <br /> with families and children. <br /> • Head Start/Early Head Start: These programs are available to low income families <br /> and families of children with special needs who qualify. KidSCope collaborates with <br /> both Chapel Hill/Carrboro Head Start and Orange County Head Start by giving and <br /> receiving referrals for families of young children. Since 2009 KidSCope has <br /> collaborated with Orange County and Chapel Hill/Carrboro Head Start programs to <br /> provide the national evidence-based parenting program for families of children who <br /> are age 3-8, The Incredible Years, funded through a grant from NC Department of <br /> Social Services. The program is designed to promote positive relationships and <br /> support parents/family members in improving parenting skills. The Incredible Years <br /> program has been very successful thanks to our Partnership with CHCCS <br /> PreK/Head Start. Classes are currently available in English and Spanish at Northside <br /> Elementary School through KidSCope. <br /> • KidSCope is a partner in the "Making Connections" Preschool Interagency Orange <br /> County Collaborative funded by the Triangle United Way. The collaborative takes a <br /> similar approach to the Family Success Alliance to address issues in FSA 6, <br /> providing supportive services for families of children birth to 5. <br /> h) Describe what would happen if requested funding is not awarded at all or if a reduced <br /> allocation is recommended. <br /> Although we would continue to seek funding from other sources, if funding is not received <br /> through this application for the KidSCope Community Outreach program, the program will <br /> not be viable, or available to Orange County children and families. <br /> i) Include any other pertinent information. <br /> Program/Project Information <br /> j) Complete the Target Population and Program Beneficiary Demographics Chart <br /> k) Complete the Schedule of Positions Chart for Program Staff <br /> I) Disclosure of Potential Conflicts of Interested must be signed <br /> m) Complete the Work Statement Chart to describe the work to be performed, and be sure to <br /> attach copies of all data collection tools that will be used to verify achievement of program <br /> goals and objectives. Describe who will be responsible for monitoring progress. <br /> Information to Complete <br /> j.) Target Population <br /> Complete the following tables to the best of your ability. Show numbers of participants and <br /> percentages, as applicable, in each category. <br /> Main Application 5/25/2016 9:13:32 AM .. g 10 of 23 <br />