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DocuSign Envelope ID: E9553E7D-3748-4C37-A9D7-602D42934ACC t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> 3. PROJECT/PROGRAM INFORMATION <br /> Agency & Program Name: _Public Gallery of Carrboro dba WCOM Community Radio <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 /> required application and required supplemental sections (Parts) as specified below: <br /> xx❑ Human Services (Main Application Only) <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 Part A AND Part B) <br /> Indicate the type of program for which you are requesting funding: <br /> Yout Elderl Disabled Public Housing <br /> Program Category Adult y (not elderly) Neighborhoods/Resident <br /> Education <br /> Health and Nutrition <br /> Job Training <br /> Sports and Arts Activities XX XX XX XX XX <br /> Pre-School Activities <br /> After-School Activities <br /> Mentoring XX XX XX XX XX <br /> Transportation <br /> Housing <br /> Other: Please specify XX <br /> Broadcasting Training & <br /> experience <br /> XX XX XX XX <br /> Program/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 /> Answers Inserted Below <br /> a) Summarize the program services proposed and how the program will address the <br /> chosen Town/County priority? <br /> b) 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. <br /> c) Describe the population to be served or the area to benefit and indicate how you will <br /> identify beneficiaries. <br /> d) Who specifically will carry out the activities and in what location will they be carried out? <br /> Main Application 5/25/2016 10:00:47 AM P 5 of 20 <br />