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DocuSign Envelope ID:4D553CF7-2BBD-4F4E-B84E-E6B8B077A9AB <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Additional Program Information <br /> k) Target Population <br /> Complete the following tables, with numbers (not percentages) of individuals served and to be <br /> served, to the best of your ability, <br /> I Program Target Population Demographics <br /> Actual Estimated Projected <br /> 2015-16 2016-17 2017-18 <br /> Gender <br /> Male 1,135 1,410 1,817 <br /> Female 929 1,229 1,612 <br /> Total 2,064 2,639 3,429 <br /> Ethnicity <br /> African-American 956 1,224 1,561 <br /> American Indian or Alaska Native 11 22 26 <br /> Asian 16 36 43 <br /> Caucasian 973 1,212 1,612 <br /> Native Hawaiian or other Pacific Islander 0 0 0 <br /> Other: specify Hispanic/Latino 108 145 187 <br /> Total 2,064 2,639 3,429 <br /> Of the above, how many Hispanic/Latino 108 145 187 <br /> Of the above, how many non-Hispanic/Latino 1,956 2,494 3,242 <br /> Total 2,064 2,639 _ 3,429 <br /> Age <br /> 0-5 years <br /> 6-18 years 29 58 69 <br /> 19-50 years 1523 1,580 2,057 <br /> 51+ years 512 1,001 1,303 <br /> Total 2,064 2,639 3,429 <br /> Geographic Location <br /> Alamance County 32 47 60 <br /> Chatham County 21 41 53 <br /> Durham County 26 32 42 <br /> Wake County 4 13 17 <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 28 41 53 <br /> Town of Chapel Hill (Non-Public Housing) 621 789 1,039 <br /> Town of Carrboro 629 778 994 <br /> Town of Hillsborough 72 101 137 <br /> City of Mebane(Orange County) 24 49 64 <br /> Orange County(Outside Municipalities) 596 729 946 <br /> Other 11 19 24 <br /> Total I 2,064 _ 2,639 3,429 <br /> DO NOT SUBMIT THIS PAGE 1/31/2017 11:11:58 AM Page 14 of 3 <br />