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Exhibit 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 /> 2014-2015 2015-2016 2016-2017 <br /> Program Activity 1 Present educational programs to youth and adults in the communit . <br /> Program Goal OCRCC will provide OCRCC will provide OCRCC will provide <br /> educational programs to educational programs to educational programs to <br /> 13,010 individuals. 13,010 individuals. 13,200 individuals. <br /> Performance Measures Program Record sheets maintained and monitored by OCRCC education staff. <br /> Program Results OCRCC provided educational <br /> programs to 13,614 individuals <br /> in the community. <br /> 115-�.. te ` . �E ��E� <br /> ME <br /> Program Activity 2 Present Safe Touch educational programs in elementary schools. <br /> Program Goal 90%of teachers and counselors whose classrooms receive Safe Touch programs will report an <br /> increase in student awareness of personal safety and protection against sexual violence. <br /> Performance Measures For each program within a school setting,the OCRCC provides each teacher and school counselor <br /> with an evaluation asking them to assess whether the program resulted in an increased awareness <br /> of personal safety and protection against sexual violence among students. OCRCC staff reviews <br /> evaluations periodically and compiles results biannually. <br /> Program Results 95%of teachers and <br /> counselors at schools that <br /> receive OCRCC programs <br /> reported an increase in student <br /> awareness of personal safety <br /> and protection against sexual <br /> violence. <br /> Main Application 1/25/2016 12:55:42 PM P a g e 2 4 o f 3 2 <br />