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onnunign Envelope ID:rnnCoAo2-o7Eo-4:oe+FAn-CencAn71eAno [ /\- QoOtinu8d <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Of the females how many are single- <br /> female Head of Households (Omit for <br /> Human Services) n/a n/a n/a <br /> Ethnicity <br /> African-American 'i/o 20% <br /> American Indian or Alaska Native 96 <br /> Asian 3% 2% <br /> Caucasian <br /> Native Hawaiian or other Pacific <br /> Islander 1% 3% 4% <br /> Other <br /> Total 10096 100% 100%i <br /> Of the above how many � ------- -- - <br /> Hispanic/Latino UNKNOWN UNKNOWN UNKNOWN <br /> Of the abmve how many non' <br /> H(spanic/Lahmo UNKNOWN UNKNOWN <br /> Total | 5.00O � 5.O0O � 5.000 <br /> Age <br /> 0-5 years <br /> 6-18 years <br /> 19-50 years <br /> 51-61 years <br /> 62+ years <br /> Total <br /> Geographic Location <br /> Durham City UNKNOWN UNKNOWN UNKNOWN <br /> UNKNOWN UNKNOWN UNKNOWN <br /> Durham County <br /> UNKNOWN UNKNOWN UNKNOWN <br /> Car rboro <br /> I)NKNowN LAKNOWN UNKNOWN <br /> Chapel Hill <br /> UNKNOWN UNKNOWN UNKNOWN <br /> Chap& HUl Public Housing Residents <br /> UNKNOWN UNKNOWN UNKNOWN <br /> Orange County <br /> UNKNOWN <br /> I UNKNOWN UNKNOWN <br /> Raleigh <br /> UNKNOWN UNKNOWN UNKNOWN <br /> Wake County <br /> Total 0 0 0 <br /> Income Leve —See following chart <br /> (Onniitfor S) <br /> < 3O96Area Median Income <br /> 3.1-50% Area Median income <br /> 51-80% Area Median Income <br /> � <br /> 80%Area Median Income | � <br /> Main Application 1/25/2016 1:26:31 PM <br />