Orange County NC Website
Browse       Search
DocuSign Envelope ID: D2CB2439-4B3B-42E7-A090-286FDDD6E948 t A - continued <br /> Provider's Outside Agency Application <br /> Please include program staff positions followed by volunteer positions; these financial figures <br /> should match the personnel figures in your Agency Comparative Budget Excel Form. Similar <br /> positions can be combined. (i.e., 8 Occupational Therapists can be inserted as one line item). <br /> If provided, <br /> indicate: <br /> Position Titles % Projecte (R) <br /> *= Position FTE* Program Actual Estimated d Total Retirement <br /> Vacant Staff+ 2014-15 2015-16 2016-17 Budget Plan <br /> (H) Health <br /> Plan <br /> Volunteer $6,050 <br /> Coordinator 1.0 100% AmeriCorps $7,200 $0 33% <br /> Director .50 100% 0 $12,538 $20,000 66% (H) $2,000 <br /> Food Program <br /> Coordinator .08 100% $250 $500 $500 2.4% <br /> Assistant Director <br /> .50 100% Volunteer Volunteer Volunteer 0% <br /> $1,375 $1,408 $1,408 <br /> 4 Work Study .25 each,paid each,paid each,paid <br /> Students (ea) .20% by UNC by UNC by UNC 0% <br /> Volunteers 2.00 100% Volunteer Volunteer Volunteer 0% <br /> Notes: <br /> • Similar positions can be combined: i.e. 8 Occupational Therapists can be inserted as one line item. <br /> • ** Full Time Equivalent staff will be noted as 1.00; half time as .50; quarter time as .25, etc. <br /> • + Denotes the percentage of staff time involved with this program. <br /> • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: <br /> Total Volunteer Hours=Volunteer FTE <br /> 1,960 <br /> I.) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST <br />