Orange County NC Website
Browse       Search
DocuSign Envelope ID:2A83AE93-E43A-4DCA-8002-FA0D789204A6 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Community and School-Based Mentorinq <br /> Program Primary Contact and Title: Andie Thomas-Young, VP of Programs <br /> Telephone Number: 919-850-9772 E-Mail: ayoungbbbstri.org <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> I I Priority Area #1: safety-net services for disadvantaged residents <br /> X Priority Area #2: education, mentorship, and afterschool programming for <br /> youth facing a variety of challenges <br /> r Priority Area #3: programs aimed at improving health and nutrition of needy residents <br /> b) Indicate the type of program for which you are requesting funding <br /> (Check all that apply to this program) <br /> Program Category Youth Adult Elderly Disabled Public Housing <br /> Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X <br /> Family Resources X <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Please specify <br /> —Mentoring X <br /> c) Provide a bulleted list of other agencies, if any, with which your agency <br /> coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) <br /> to be funded. For each, briefly describe the coordinated/collaborative efforts. <br /> • Wake and Durham County Departments of Social Services–We have received referrals <br /> from them in the past and have current relationships in which they are assigned as the legal <br /> guardian. <br /> • North Carolina Department of Public Instruction – They endorse our programs every year <br /> by supporting our efforts to help at-risk children. <br /> • North Carolina Department of Juvenile Justice – We get referrals from them to mentor <br /> children. <br /> • Durham Housing Authority and the Housing Authority of Wake Counties– We get referrals <br /> from them to mentor children they determine are in need of our services. <br /> • JD Lewis Community Center in Raleigh <br /> PROGRAM INFORMATION 1/27/2017 1:43:18 PM Page 14 of 24 <br />