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DocuSign Envelope ID:99BDCA4A-2934-455A-8D45-0C865AD016D0 it 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. (The results and progress of all our activities and match <br /> relationships are recorded on our proprietary AIM (Agency Information Management) <br /> system, as managed and required by our national office and following all its <br /> guidelines.) <br /> • Actual Program Results use program results to indicate the actual measureable <br /> achievement of goals. If goals were not met, please explain. <br /> Main Application 5/24/2016 8:51:19 AM P of 25 <br />