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DocuSign Envelope ID:60192208-BFA3-4E38-9277-B2390FDDC97D <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> o Travel &Training <br /> o Other Expenses <br /> iii. Does your agency budget show a Surplus or Deficit? Balanced budget <br /> Is there a significant change? Yes/No Yes <br /> Please provide a brief explanation for Surplus or Deficit, and significant changes. <br /> Behavioral Insights is launching two new services in 2016-17, the Batterer Intervention <br /> Program and Strong Fathers Program. The Strong Fathers Program, which is often <br /> required of fathers involved with Child Protective Service, features no fee for participants. <br /> iv. What is your agency's fiscal year? July 1, 2017 —June 30, 2018 <br /> (Example: July 1, 2016 through June 30, 2017) <br /> Agency Information 1/30/2017 10:59:56 AM Page 1 0 of 21 <br />