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DocuSign Envelope ID: B701CF6A-1C9A-46CB-9234-56F771D80955 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> 3. PROJECT/PROGRAM INFORMATION <br /> Agency & Program Name: YMCA of the Triangle Area, Inc. / Boomerang Program <br /> a) Check the type of funding request for this application package submittal and complete the <br /> required application and required supplemental sections (Parts) as specified below: <br /> ® Human Services (Main Application Only) <br /> Indicate the type of program for which you are requesting funding: <br /> Program Category Youth Adult Elderly Disabled (not Public Housing <br /> elderly) Neighborhoods/Residents <br /> Education ✓ <br /> Health and Nutrition <br /> Job Training <br /> Sports and Arts <br /> Activities <br /> Pre-School Activities <br /> After-School Activities ✓ <br /> Mentoring <br /> Transportation <br /> Housing <br /> Other: Please specify <br /> Program/Project Description (Label your responses as outlined below; not to exceed 3 pages.) <br /> Please provide the following information about the proposed program/project: <br /> b) Summarize the program services proposed and how the program will address the chosen <br /> Town/County priority? <br /> Boomerang is the only program that offers an alternative to short-term suspension for youth in Orange <br /> County. Students receive tutoring and 1:1 counseling by licensed staff (LCSW, LPC) and participate in <br /> psycho-educational groups. There is no cost to students/families. Our principal partners for student <br /> referrals are Chapel Hill-Carrboro City Schools, Orange County Schools and the Department of Juvenile <br /> Justice. In addition, Boomerang's after school programming provides wrap-around support to students at <br /> risk of disconnection. These services include tutoring, community service and service learning projects, and <br /> individual brief crisis counseling. <br /> Boomerang's programming aligns with the Chapel Hill Town Council's goal for 2014-16 to "Create A <br /> Strategy For Out Of School Time For Youth", and supports the goal to "Review and Refine Focus for Youth <br /> Services and Begin Planning for Youth-Centered Facilities". <br /> Boomerang's after school programs respond in part to the community's need for "low-cost/free activities <br /> that positively engage children and youth, especially those from at-risk and low-income households." (2012 <br /> report on Human Service Needs in Chapel Hill, under Education and Family Resources: Youth support and <br /> activities) <br /> As a member of Orange County Family Success Alliance, Boomerang is working collaboratively to respond <br /> to the need for "an integrated system of human services in which agencies not only assist individuals in <br /> Main Application 5/24/2016 9:22:20 AM 0:' a g c 6 of 2 I <br />