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DocuSign Envelope ID: oC/+8002FA0o789204A6 <br /> EXHIBIT A <br /> PROVIDERS OUTSIDE AGENCY APPLICATION <br /> Additional Program Information <br /> I) Target Population - Complete the following ta@eS, with numbers (not percentages) <br /> Of individuals served and to be served, to the best of your ability, <br /> Program Target Population Demographics <br /> Actual Estimated Projected <br /> 2015'16 2016-17 2017-18 <br /> Gender <br /> Male 514 494 528 <br /> Female 554 536 572 <br /> Total 1068 1030 1100 <br /> Ethnicity <br /> African-American 787 762 814 <br /> American Indian or Alaska Native 0 <br /> Asian 4 4 4 <br /> Caucasian 102 103 110 <br /> Native Hawaiian or other Pacific Islander 0 0 0 <br /> Other: specify Multi-race 175 165 176 <br /> Total 1088 1030 1100 <br /> Of the above, how many Hispanic/Latino *I calculated <br /> these from the"other"category-not from the grand total 9 8 9 <br /> Of the above, how many non'Hiapanin/LeMnn* 106 157 167 <br /> Total 175 165 176 <br /> Age <br /> 0-5 years 0 <br /> 6-18 years 1061 1020 1088 <br /> 19-50 years 7 10 11 <br /> � <br /> 51+ years <br /> Total 1068 1030 1100 <br /> Geographic Location <br /> Alamance County 0 <br /> Chatham County 0 <br /> Durham County 376 361 385 <br /> Wake County 551 536 572 <br /> _ <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 0 <br /> Town of Chapel Hill (Non-Public Housing) 103 101 108 <br /> Town of Carrboro 1111 19 22 <br /> Town of Hillsborough ISM= 10 9 <br /> City of Mebane (Orange County) 1 ME= 1 <br /> (]range County(Outside Municipalities) 4 2 3 <br /> Total 1068 1030 1100 <br /> , <br /> PROGRAM INFORMATION 1/27/2017 1 :43:18 PM Page 18 of 24 <br />