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DocuSign Envelope ID: 5F353138-C664-4703-97A3-A28BCE0500B7 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 2. AGENCY INFORMATION (Be Very Brief and Concise) <br /> Please provide the following information about your agency (2 pages OR LESS): <br /> a) Years in Operation *, Date of Incorporation (Month/Year): August 24, 2015 <br /> * Boomerang was a program of the Chapel Hill-Carrboro YMCA from January 2006 to <br /> June 2016. <br /> Boomerang Youth, Inc., was incorporated on August 24, 2015 (Articles of Incorporation <br /> accepted by NC Secretary of State), but operated under the YMCA until July 1, 2016. <br /> On July 1, 2016, Boomerang officially separated from the YMCA to begin operations as <br /> Boomerang Youth, Inc., an independent 501(c)3 organization. <br /> b) Agency's Purpose/Mission (no more than a few sentences): <br /> Boomerang inspires youth to bounce back from challenges and move towards positive <br /> change. We provide youth with the support they need in times of crisis and beyond, to <br /> manage their challenges, cope with adversity and become resilient, independent young <br /> people. We strive to disrupt the school-to-prison pipeline by providing alternative-to- <br /> suspension and after school programming for middle and high school students in Chapel <br /> Hill-Carrboro City Schools and Orange County Schools. Services are provided at no cost to <br /> students/families. To date, Boomerang has served over 2500 students through its programs. <br /> c) Types of Services the Agency Provides (bullet format): <br /> • Alternative to Suspension <br /> • Continuing Connections After School <br /> o What's Next? skill-building workshops for middle and high school students <br /> o Homework Help & Tutoring <br /> o Support on Demand: brief counseling, intervention and support for students <br /> o Community Service & Service Learning projects <br /> d) Agency's History with Providing These Services: <br /> 2006: Boomerang is launched as a pilot alternative to suspension program in <br /> January, serving one CHCCS middle and one high school <br /> 2006: District Court Judge mandates that all CHCCS court-involved youth attend <br /> Boomerang when short-term suspended from school <br /> 2007: Boomerang expands services to all CHCCS middle and high schools <br /> 2008: Boomerang expands services to court-involved youth in Orange County <br /> 2008: Boomerang becomes an approved adult community service site <br /> 2008: Boomerang and Volunteers for Youth enter an agreement for court- involved <br /> Orange County youth aged 16 and younger to complete court-ordered <br /> community service hours at Boomerang <br /> 2009: Boomerang offers after school hours on Wednesdays-Fridays <br /> 2010: Boomerang offers community service hours during the summer break <br /> 2011: Boomerang expands services to Orange County Schools <br /> 2011: Boomerang expands to a 5-day program in September, including afterschool <br /> programming (Tues-Thurs) and summer programming <br /> I ' ago 1 o of 15 <br />