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000wSWn Envelope ID:A05Er081'o 3roCrE [ /\ - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget <br /> P|aaoa complete a Program Budget Excel Form for each requested program. The Program Budget <br /> should reflect only figures and amounts associated with the Program(o) for which you are seeking <br /> funding and not the total agency budget. If the pmgranfo finances experienced significant changes <br /> that you would like to axp|ain, please use the space ba|ovx <br /> Agency/Program:Habitat for Humanity of Orange County,A Brush with Kindness <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE <br /> Private Donations <br /> Agency Generated Revenue (feeo) <br /> Local Government Grants: wwwiiiiw <br /> Orange County <br /> Town of Chapel Hill <br /> Town ofCanboro <br /> Other Loca|:{%}BG Funds <br /> Other Local:/UHDR1Funds <br /> Other Loca|:ln/a <br /> U more than 3 sources, please provide aseparate <br /> list. <br /> Nun'Luoo| Government Grants <br /> Triangle United Way 0$ - 0$ 10$ 1"0 <br /> State Government <br /> Federal Government <br /> Other Grants:ln/& <br /> Other Grants:ln/& <br /> K8iooeUoneouoNOtherRevenue <br /> Please list 3 largest MiscaUanou000urcao: <br /> n/a <br /> Total Agency Revenue <br /> AGENCY EXPENSES <br /> Compensation <br /> Rent & Utilities <br /> Supplies& Equipment <br /> Travel &Troinin0 <br /> Other Expenses: <br /> Please list 3 largest"Other Expenses": <br /> Cost of Construction: $27,000 <br /> n/a <br /> Total Agency Expenses <br /> GURPLUG/(DEF|C|T) FOR PERIOD: <br /> Main Application 1/25/2016 12:11 :11 PM 7 <br />