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DocuSign Envelope ID:F9ADA870-944A-40DD-98D0-3DB55F3AD8E5 <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): 33 years in operation; <br /> incorporated November 30, 1983 <br /> b) Agency's Purpose/Mission (no more than a few sentences): Creating opportunities <br /> for students and teachers <br /> c) Types of Services the Agency Provides (bullet format): <br /> • The Chapel Hill-Carrboro Public School Foundation (PSF) is both a fundraiser <br /> and a grant-maker. <br /> • In order to fund our grant programs, we apply for grants that we can then re- <br /> grant, receive donations from local businesses and donors, and also have <br /> endowments that generate funds for our five grant categories. <br /> • Over $180,000 was distributed to teachers, principals, and staff in our school <br /> district last year through the grant programs. <br /> • PSF also hosts a number of fundraising events, including a Walk for Education, <br /> which mobilizes community support and enables schools to generate funds for <br /> their needed programs. Through the Walk for Education, over $100,000 was <br /> raised by individual schools in the Chapel Hill-Carrboro City Schools District in <br /> 2015-16 for their own use. We operate a Teacher Supply Store in partnership <br /> with the East Chapel Hill Rotary Club and provide free school supplies to <br /> teachers for use by their students in the classroom—a $75 value to each <br /> teacher who participates. Our 5K for Education targets teachers and staff, in <br /> addition to parents, students, and community members, and generates funds for <br /> CHCCS schools and PSF grants. The "Teachers First Breakfast and Roses" <br /> kicks off Teacher Appreciation Week every year with a wonderful breakfast for <br /> teachers and staff. Funds raised--over $90,000 last year--are used for teacher <br /> programs. <br /> • PSF has eleven endowed teaching chairs that allow us to recognize our <br /> outstanding teachers annually. <br /> • Additionally, we received funds through annual Board Campaigns and direct <br /> mail campaigns. <br /> d) Agency's History with Providing These Services: The Public School Foundation submits <br /> and receives grants for numerous educational programs annually and acts as the <br /> overseeing agent for the implementation of these programs. Specifically, PSF has <br /> funded after school tutoring at various Chapel Hill-Carrboro city Schools on some level <br /> since the creation of our Achievers' Fund in 2011. <br /> e) Other Pertinent Agency Information: The Chapel Hill-Carrboro Public School Foundation <br /> (PSF) is the only independent, non-profit organization that is dedicated to mobilizing <br /> community support for the Chapel Hill-Carrboro City Schools. We are fundraisers and <br /> grant makers. We believe that all students deserve the best possible education and <br /> that teachers are our most valuable resource. PSF is the fiscal agent for the Blue <br /> Ribbon Mentor Advocate Program, but does not have authority over the programming. <br /> f) Schedule of Positions (For Entire Agency) <br /> • Full Time Equivalent(FTE) staff will be noted as 1.00; half time as .50; quarter time as .25, etc. <br /> • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: <br /> Agency Information 1/27/2017 11:05:52 AM Page 8 of 2 2 <br />