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DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357 I A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> 3. PROJECT/PROGRAM INFORMATION <br /> Agency & Program Name: Senior Care of Orange County; Inc. <br /> Florence Gray Soltys Adult Day Health Program <br /> As you complete your application, complete only those sections that pertain to the type of <br /> application you are submitting. The application is divided into several sections and not all sections <br /> apply to every project. Every applicant MUST complete the main application. <br /> a) Check the type of funding request for this application package submittal and complete the <br /> application and supplemental application sections as specified below: <br /> X Human Services (Main Application Only) <br /> AH Non-Construction (Main Application Only) <br /> AH Construction —(Main Application AND Part B) <br /> • AHDR Non-Construction (Main Application Only) <br /> n AHDR Construction — (Main Application AND Part B) <br /> I I CDBG Non-Construction — (Main Application AND Part A) <br /> El CDBG Construction — (Main Application AND Part A AND Part B) <br /> El HOME CHDO Set-aside — (Main Application AND Part A) <br /> n HOME Other —(Main Application AND Parts A AND Part B) <br /> Indicate the type of program for which you are requesting funding: <br /> Disabled Public Housing <br /> Program Category Youth Adult Elderly (not Neighborhoods/Resid <br /> elderly) ents <br /> Education <br /> Health and Nutrition X X X <br /> Job Training <br /> Sports and Arts <br /> Activities <br /> Pre-School Activities <br /> After-School <br /> Activities <br /> Mentoring <br /> Transportation <br /> Housing <br /> Other: Please <br /> specify Adult Day <br /> Care/Health Program <br /> _ X X X <br /> Program/Project Description (Label your responses as outlined below; not to exceed 3 <br /> pages.) <br /> Please provide the following information about the proposed program/project: <br /> b) Summarize the program services proposed and how the program will address the <br /> chosen Town/County priority? This is a request to continue with the financial support provided to <br /> the Florence Gray Soltys Adult Day Health Program under the auspices of Senior Care of Orange County, <br /> Inc. This program originally started by the County Department on Aging as a major Master Aging Plan <br /> Main Application 1/25/2016 12:26:51 PM Page 8 of 21 <br />