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DocuSign Envelope ID: 5BF9183D-3BD5-4FD7-80DE-F437539D2E9F 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 /> The Executive Director The Executive Director <br /> provided Heritage Education provides Heritage Education From 7.1.16-16.30.17, OCHM <br /> Programs, both in the Programs and participates in <br /> Program Activity 1: Use NC K-12 collaborative events. will incorporate NC Essential <br /> classroom and at the <br /> Essential Standards,deliver Traveling Trunks are rented Standards/revised Bloom's <br /> Heritage Education program, Museum. The Executive Taxonomy, revise/deliver <br /> Director rents Traveling to teachers. y, <br /> outreach/onsite NC/OC <br /> Trunks to teachers and lesson plans through <br /> participates in collaborative illustrated presentations, <br /> history events. group discussions, and <br /> intoror4km nrniortc <br /> Provide interactive history- <br /> Serve at least 2,500 based learning that supports <br /> children by providing Serve at least 2,500 children NC social studies Essential <br /> Program Goal Heritage Education by providing Heritage Standards to 2500 OC K-5th <br /> Programs, Traveling Education Programs, graders by June 30 2017. <br /> Trunks, or through Traveling Trunks, or through Venues: K-5 schools, <br /> Collaborative History Collaborative History <br /> Events. HFD/Hillsborough, OCHM <br /> The Executive Director The Executive Director will The Executive Director will <br /> Performance Measures recorded the number of record the number of children record the number of children <br /> children served during served. served during each outreach <br /> each outreach. contact in FY16-17. <br /> The Executive Director will: <br /> provide curriculum based <br /> 2590 Orange County Heritage Education Programs <br /> children were served The Museum anticipates at to 2500 culturally diverse <br /> Program Results through Museum's least 2,500 Orange County students in FY 16-17, - <br /> Heritage Education children will be served by one participate in collaborative <br /> Programs, Traveling of the Museum's Heritage events, <br /> Trunks or by attending a Education Programs -rent traveling trunks to <br /> collaborative history event. teachers. <br /> Main Application 5/25/2016 9:07:15 AM .. , 'if of <br />