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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 /> Please indicate whether this project/program will serve: ® Persons ❑ Households ❑ Units <br /> Program: KidSCope Community Outreach Program <br /> Program Beneficiary Demographics <br /> Actual Estimated Projected <br /> 2014-15 2015-16 2016-17 <br /> Gender <br /> Male 58 53 57 <br /> Female 43 38 44 <br /> Total 101 91 101 <br /> Of the females, how many are single- <br /> female Head of Households (Omit for <br /> Human Services) <br /> Ethnicity <br /> African-American 22 28 28 <br /> American Indian or Alaska Native 0 0 0 <br /> Asian 3 2 3 <br /> Caucasian 32 45 31 <br /> Native Hawaiian or other Pacific <br /> Islander 0 0 0 <br /> Other 44 16 39 <br /> Total 101 91 101 <br /> Of the above, how many <br /> Hispanic/Latino 30 28 30 <br /> Of the above, how many non- <br /> Hispanic/Latino 71 63 71 <br /> Total 101 91 101 <br /> Age <br /> 0-5 years 101 91 101 <br /> 6-18 years <br /> 19-50 years <br /> 51-61 years <br /> 62+ years <br /> Total 101 91 101 <br /> Geographic Location <br /> Durham City 1 0 1 <br /> Durham County 0 0 0 <br /> Carrboro 16 14 16 <br /> Chapel Hill 38 32 36 <br /> Chapel Hill Public Housing Residents Don't track Don't track Don't track <br /> Orange County 46 45 48 <br /> Raleigh 0 0 0 <br /> Wake County 0 0 0 <br /> Main Application 5/25/2016 9:13:32 AM P g 1 of 23 <br />