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DocuSign Envelope ID:B32F3E9 3514F2E575e [ /\- continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Of the above, how many <br /> Hispanic/Latino 9,5% 15% 18% <br /> Of the abmve, how many non' <br /> Hiapanio/Latino 90,5Y6 85% 82% _____ <br /> Total 100Y6 10094 100%_ <br /> Age <br /> 0-5 years 296 6�� 10%�0 <br /> ------ — ----T -- <br /> 6'18 years 98% I 95% 90% <br /> 19-50 years -- — <br /> 51-01 years -- �- — <br /> 62+ years — <br /> Total 100Y6 �O096 100% <br /> Geographic <br /> location <br /> estimated for <br /> Geographic Location 2014-2015 <br /> Durham City <1% <196 I <1% <br /> Durham County -- <1`)/0,� <br /> I �__�� <br /> Carrboro 25% 2096 22% <br /> Chapel Hill 55% 52% 48% <br /> Chapel Hill Public Housing Residents 19% 25% <br /> Orange County <1% . <1Y4 <br /> Raleigh I -- -- <br /> Wake County <196 | �1�� <1% <br /> Total 100% � 100Y4 I 100% <br /> Income Leve —See following chart <br /> (Omit for HS) <br /> 1. <br /> < 3096 Area Median Income <br /> �-------- i <br /> 31-50% Area Median Income <br /> 51'8O96 Area Median Vnonme <br /> > 80% Area Median Income <br /> Total ' 0 0 0 <br /> Special Needs (Omit for HS) <br /> Elderly (Over 62) <br /> |- / ---------- <br /> Disabled (not elderly) <br /> Homeless <br /> People with HUV/Aids � � <br /> Total 0 I 0 0 <br /> Main Application 1/25/2016 11:34:49 AM 1 r) 2 I <br />