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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 /> m.) Work Statement <br /> This form is used to document program activities, program goals, performance measures, <br /> and actual results. (Add more rows as needed) If this is a new program, you will only <br /> document the projected information. <br /> • Program Activities should outline major activities the agency implements to accomplish its <br /> program goals. <br /> • Program Goal should explain what the program is trying to achieve/accomplish. Goals are <br /> statements about what the program should accomplish. SMART Goals <br /> • Performance Measures describe how you will evaluate the degree in which you achieved <br /> the stated goals. <br /> • Actual Program Results use program results to indicate the actual measureable <br /> achievement of goals. If goals were not met, please explain. <br /> Actual Estimated Projected <br /> 2014-15 2015-16 2016-17 <br /> Program Activity 1 Broadcasting Broadcasting Broadcasting <br /> Program Goal Broadcast 100%of time Broadcast 100%of time Broadcast 100%of time <br /> Performance Measures Time we broadcast Time we broadcast Time we broadcast <br /> Program Results 99.7% (malfunctions) 99.9% (malfunctions) 100% <br /> Program Activity 2 Training Training Training <br /> Program Goal Train 10 broadcasters Train 13 broadcasters Train 15 broadcasters <br /> Performance Measures Number trained Number trained Number trained <br /> Program Results 12 13 15 <br /> Program Activity 3 Add new programming Add new programming Add new programming <br /> Program Goal 5 new shows 6 new shows 7 new shows <br /> Performance Measures Number added Number added Number added <br /> Program Results 6 6 7 <br /> Program Activity 4 <br /> Program Goal <br /> Performance Measures <br /> Program Results <br /> Activity 5 <br /> Program Goal <br /> Performance Measures <br /> Program Results <br /> Main Application 5/25/2016 10:00:47 AM .. g 13 of 20 <br />