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oocuGNn Envelope|o o2Ce2z1.394e3e42E7,A030-288F0008E9z1.13 [ /\ - continued <br /> Provider's Outside Agency Application <br /> m.) Work Statement <br /> This form is used to document program 3[tividgS, program goals, performance <br /> measures, and actual results. (Add more rows as needed) If this is a new program, you <br /> will only document the pr jected information. <br /> • Program Activities should outline major activities the agency implements to accomplish <br /> its program goals. <br /> • Program Goal should explain what the program is trying to achieve/accomplish. Goals <br /> are statements about what the program should accomplish. SMART Goals <br /> • Performance Measures describe how you will evaluate the degree in which you <br /> achieved the stated goals. <br /> • Actual Program Results use program results to indicate the actual measurable <br /> achievement of goals. If goals were not met, please explain. <br /> Actual <br /> Estimated <br /> 2015-2016 Projected <br /> Program Activity 1 <br /> Program Goal <br /> Performance Measures <br /> Pro:ram Results <br /> Program Activity 2 <br /> Program Goal <br /> Performance Measures <br /> Program Results <br /> Program Activity 3 <br /> Program Goal <br /> Performance Measures <br /> Program Results <br /> Program Activity,4 <br /> Pro:ram Goal <br /> Performance Measures <br /> Program <br /> Program Activity 5 <br /> Performance Measures 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> Program Results <br />