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DocuSign Envelope ID: 5F353138-C664-4703-97A3-A28BCE0500B7 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Boomerang -Alternative to Suspension & Continuing Connections After School <br /> Program Primary Contact and Title: Sonia Frischemeier, Director of Operations <br /> Telephone Number: (919) 968-2146 E-Mail: Sonia.Frischemeier©BoomerangYouth.org <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> ❑ Priority Area #1: safety-net services for disadvantaged residents <br /> ® Priority Area #2: education, mentorship, and afterschool programming for <br /> youth facing a variety of challenges <br /> ❑ Priority Area #3: programs aimed at improving health and nutrition of needy residents <br /> b) Indicate the type of program for which you are requesting funding <br /> (Check all that apply to this program) <br /> Program Category Youth Adult Elderly Disabled Public Housing <br /> Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X <br /> Family Resources <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: After School X <br /> c) Provide a bulleted list of other agencies, if any, with which your agency <br /> coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) <br /> to be funded. For each, briefly describe the coordinated/collaborative efforts. <br /> • School districts - Chapel Hill-Carrboro City Schools and Orange County schools — <br /> are core partners in coordinating services provided to suspended students and <br /> transitioning them back to school. <br /> • Department of Juvenile Justice is a core partner in coordinating services and follow-up <br /> with court-involved students. <br /> • UNC Outpatient Substance Abuse Clinic provides weekly workshops on substance <br /> use to supplement Boomerang's assessments and psycho-educational skill-building <br /> activities; an important service as substance use has been the most common reason for <br /> suspension over the last 2 years. <br /> • Dispute Settlement Center provides bi-monthly skills-building sessions in conflict <br /> resolution to supplement Boomerang's conflict and communication skill-building <br /> II:' g of 15 <br />