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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 /> Actual Estimated Projected <br /> 2014-2015 2015-2016 2016-2017 <br /> - 1 <br /> Program Activity 1 <br /> 75%of all eligible students will 75%of all eligible students will <br /> 80%of all eligible students will attend Boomerang and complete attend Boomerang and complete <br /> attend Boomerang when referred the program when referred during the program when referred during <br /> Program Goal during their suspension their suspension. their suspension. <br /> School referral forms;daily School referral forms;daily <br /> School referral forms;daily attendance records,qualitative attendance records,qualitative <br /> attendance records,qualitative notes on student's participation notes on student's participation <br /> notes on student's participation and behavior;student progress and behavior,student progress <br /> and behavior;service notes. notes to schools/court;internal notes to schools/court;internal <br /> Performance Measures service notes. service notes. <br /> Of the 179 referrals,146 attended 112 of 150 referrals will 112 of 150 referrals will <br /> successfully/satisfactorily successfully/satisfactorily <br /> Program Results Boomerang X82%). complete the program. complete the program. <br /> Program Activity 2 <br /> Youth will participate in at least Youth will participate in at least <br /> 50%of Boomerangs community 50%of Boomerang's community <br /> service days,engaging in projects service days,engaging in projects <br /> that enhance connections between that enhance connections between <br /> 75%of students participating in individuals and the community; individuals and the community; <br /> community service at Boomerang enhance life skills;and facilitate enhance life skills;and facilitate <br /> will complete at least 5 hours of connections with positive adults connections with positive adults <br /> Program Goal service and youth peers in the community. and youth peers in the community. <br /> Incoming community service Incoming community service <br /> Incoming community service referral forrru,daily tirnesheets, referral forms,daily tirnesheets, <br /> referral forrru,daily tirnesheets, reports to Volun teers for Youth reports to Volunteers for Youth <br /> reports to Volunteers for Youth and Adult Community Service, and Adult Community Service, <br /> Performance Measures and Adult Community Service. youth surveys. youth surveys. <br /> At least 30 youth will participate in At least 30 youth will participate in <br /> cornmunity service projects and at community service projects arrd at <br /> least 15 youth will self-report least 15 youth will self-report <br /> learruing/improving skills,and learning/improving skills,and <br /> 68%completed at least 5 hours of improved connectedness to improved connectedness to <br /> Program Results communityservice at Boomerang. community. community. <br /> - 1 <br /> Program Activity 3 <br /> 75%of youth attending What's 75%of youth attending What's <br /> 50%of youth attending <br /> Next?life skills workshops wil Next?life skills workshops wil <br /> Boomerang's"What's Next?" <br /> workshops will attend at least 2 report having improved knowledge report having significantly <br /> of subject area or learned improved knowledge of subject <br /> group sessions. <br /> Program Goal something new. area. <br /> Success is measured bycalculating <br /> the number of youth who attend <br /> at least two"What's Next"group <br /> sessions during the 2014-15 <br /> school year and comparing th s <br /> with the number who attend just <br /> Performance Measures one. Post session surveys Post-session surveys <br /> 32%:38 attended 30 out of 40 youth will improve 30 out of 40 youth will improve <br /> Program Results 12 attended more than one knowledge/learn something new knowledge/learn something new. <br /> Program Activity 4 <br /> 50%of youth identified for 50%of youth identified for 50%of youth identified for <br /> intensive follow up services show intensive follow up services show intensive follow up services show <br /> an increase in social an increase in social an increase in social <br /> connectedness by the end of the connectedness by the end of the connectedness by the end of the <br /> Program Goal school year. school year. school year. <br /> Post surveys/evidence of Readiness to Change scale;post Readiness to Change scale;post <br /> engagement in activities,teacher surveys/evidence of engagement surveys/evidence of engagement <br /> and parent feedback,grades, in activities,teacher and parent in activities,teacher and parent <br /> compliance with school rules, feedback,grades,compliance with feedback,grades,compliance with <br /> Performance Measures decreased recidivism. school rules,decreased recidivsm, school rules,decreased recidivsm. <br /> 6 out of 12 students in the 6 out of 12 students in the <br /> 80%-15 students were tracked intensive follow up component will intensive follow up component will <br /> 1.2 students showed increase in show an increase in show an increase in <br /> Program Results connectedness. connededness. connectedness. <br /> Main Application 5/24/2016 9:22:20 AM Pdgo, 1 . of 2o <br />