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DocuSign Envelope ID: ED6C5D54-7108-4169-9541-C2FDA3EC8CA6 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 /> Emergency preparedness <br /> Program Goal 75 75 75 <br /> Performance Measures 75 75 <br /> Program Results 75 75 75 <br /> Affordable housing <br /> Program Goal 15 15 75 <br /> Performance Measures 15 15 <br /> Program Results 15 15 75 <br /> Computer classes <br /> Program Goal N/A 20 20 <br /> Performance Measures N/A 20 <br /> Program Results N/A 15 20 <br /> Main Application 5/25/2016 9:25:11 AM P 1 ,1 of 20 <br />