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Exhibit A- continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> 3. PROJECT/PROGRAM INFORMATION <br /> Agency & Program Name: The Arc of the Triangle Social and Volunteer Opportunities <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 /> ❑ AHDR Construction—(Main Application AND Part B) <br /> ❑ CDBG Non-Construction —(Main Application AND Part A) <br /> ❑ CDBG Construction —(Main Application AND Part A AND Part B) <br /> ❑ HOME CHDO Set-aside —(Main Application AND Part A) <br /> ❑ HOME Other—(Main Application AND Parts A AND Part B) <br /> Indicate the type of program for which you are requesting funding: <br /> Program Category Youth Adult Elderly Disabled Public Housing <br /> (not elderly) Neighborhoods/Residents <br /> Education x <br /> Health and Nutrition x <br /> Job Training x <br /> Sports and Arts <br /> Activities x <br /> Pre-School Activities <br /> After-School <br /> Activities x <br /> Mentoring x <br /> Transportation x <br /> Housing <br /> Other: Please <br /> specify <br /> Proaram/Project Description (Label your responses as outlined below; not to exceed 3 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 chosen <br /> Town/County priority? The Arc of the Triangle provides supports and services to more than <br /> three hundred children and adults with intellectual and developmental disabilities. A <br /> majority of our services are paid for through limited Medicaid or State funding. The funding <br /> that we are requesting would be used to offset the cost to provide educational and social <br /> experiences that are not funded through Medicaid or State funding. <br /> c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or <br /> other community priorities (i.e. Council/Board Goals). Cite local data to support the need <br /> for this program and the population being served. People with Intellectual and <br /> Main Application 5/25/2016 10:10:25 AM Page 8 of 2 <br />