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DocuSign Envelope ID:F9ADA870-944A-40DD-98D0-3DB55F3AD8E5 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> methods to address these challenges is to engage students in on-going leadership <br /> and service-learning opportunities. <br /> Opportunities are provided to students through leadership training and local <br /> service-learning. Students are able to assume leadership roles in this organization <br /> that they may not participate in otherwise. Service-learning activities give students <br /> social and cultural exposure experiences to find real-world relevance for things they <br /> are learning in school, and give them meaningful experiences to share on their <br /> college applications. We believe that providing students with these opportunities <br /> will allow them to become successful in school and beyond. These opportunities <br /> allow them to develop leadership skills within their schools and communities. The <br /> program has been operating successfully since 1999. <br /> f) Who is your target population of individuals to benefit from this program and how will they <br /> be identified and connected with the program? <br /> The Youth Leadership Institute serves high school students of color and specifically <br /> targets African American and Latino students (we serve a small amount of <br /> Burmese/Karen students). However, the program is open to all high school students <br /> and includes White, Asian, Middle Eastern, Pacific Islander, and multiracial <br /> students. All high students in Blue Ribbon Mentor-Advocate participate in YLI. Other <br /> students are referred to the program through school family specialists, counselors, <br /> community members, and parents. Students are also recruited through school club <br /> recruitment fairs. Any student who wishes to participate in the YLI program may do <br /> so. Students will participate in a summer youth leadership weekend camp at Camp <br /> New Hope, Chapel Hill, NC. Students will develop leadership skills that will <br /> empower them to use their voice and create change for all students. Once the <br /> school year begins, students will meet bi-monthly at their school during lunch. Each <br /> month, students are encouraged to participate in a local service-learning project. <br /> Students who attend at least 10 YLI meetings during lunch and complete at least 10 <br /> YLI service-learning projects are eligible for the alternative spring break trip outside <br /> of North Carolina. <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 /> Lorie Clark, the BRMA High School Specialist, plans and implements activities for <br /> Youth Leadership Institute. There is also an AmeriCorps Member who is employed <br /> full-time through the AmeriCorps program who assists with programming for <br /> students and supervises an evening tutorial at a local community center. Both <br /> provide workshops to students during their lunch periods and check in with students <br /> as they progress towards post-secondary opportunities. They provide mentoring <br /> and support to high school students. Additionally, they plan college tours, an <br /> alternative spring break trip, and cultural and enrichment opportunities for students. <br /> Activities are carried out at all four CHCCS district high schools and service sites. <br /> PROGRAM INFORMATION 1/30/2017 9:08:16 AM Page 13 of 2 2 <br />