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DocuSign Envelope ID: 5F353138-C664-4703-97A3-A28BCE0500B7 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> • Social Justice Values: <br /> o Foster a community culture that rejects oppression and inequity. <br /> o Ensure economic self-sufficiency. <br /> o Create a safe community. <br /> o Enable full civic participation. <br /> Goal 1: Ensure a community network of basic human services and <br /> infrastructure that maintains, protects, and promotes the well-being of all <br /> county residents. <br /> Boomerang is a community member of Family Success Alliance (FSA); our work falls <br /> under the following goals of FSA's Strategic Plan 2016-2018: <br /> - Goal 2: Children and youth are healthy and succeed in school <br /> - Goal 3: Youth graduate from high school and college. <br /> Goal 6: Ensure a high quality of life and lifelong learning that champions <br /> diversity, education at all levels, libraries, parks, recreation, and animal <br /> welfare. <br /> Specifically, EDUCATION: AT-RISK CHILDREN <br /> Continue to close the achievement gaps and end the school to <br /> prison pipeline. <br /> • Carrboro Board Priorities: E. Enhance and sustain quality of life/place issues for <br /> everyone <br /> 7. Help citizens develop a human environment that promotes trust, mutual <br /> respect, acceptance, happiness and well being. (Planning) <br /> f) Who is your target population of individuals to benefit from this program and how will they be <br /> identified and connected with the program? <br /> Boomerang primarily serves youth ages 11-19 in Orange County. Please note, we continue <br /> to provide support to a small cohort of young people who are now beyond this age range, <br /> but who return to us after middle and/or high school for support and mentorship. Youth are <br /> referred by the two school districts, juvenile justice system and other non-profits whose work <br /> supports at risk youth including Family Success Alliance and Orange County Misdemeanor <br /> Diversion Program. <br /> g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program <br /> Manager and credentials, describe training provided to volunteers, etc.) <br /> Direct Support Staff Administration <br /> Executive Director (LCSW) Executive Director <br /> Program Manager (LCSW-A) Director of Operations <br /> Program Manager (vacant) Office Manager <br /> MSW Intern <br /> Direct services are provided by licensed staff (LCSW, LCSW-A or MSW) with graduate <br /> degrees in Social Work or Counseling, or equivalent experience working with vulnerable <br /> youth. Direct support staff is assisted by an MSW intern (UNC-Chapel Hill School of Social <br /> Work). Licensed staff participates in Continuing Education throughout the year to keep in <br /> Page 11 of 15 <br />