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DocuSign Envelope ID:2A83AE93-E43A-4DCA-8002-FA0D789204A6 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Next Year Projected Results We have a goal of serving 1100 children in our service area. <br /> Our AML will be 32 months for Community-Based Matches <br /> and 24 months for School-Based Matches. <br /> 2. Program Activity Name <br /> Program Goal <br /> Performance Measures <br /> Previous Year Program Results <br /> Current Year Estimated Results <br /> Next Year Projected Results <br /> 10111 <br /> 10110111 110111 I'll, 111111111 111111 guidon 1,11 1111111111111111.111,111witoolloolliiiiiimilivioullinummuolohill 1111111111 1111111d 11111,11, imioH111111 11111 IT <br /> 3, Program Activity Name <br /> Program Goal <br /> Performance Measures <br /> Previous Year Program Results <br /> Current Year Estimated Results <br /> Next Year Projected Results <br /> 11,11'111111111iikilii0410%11111111111111111111111fiplphl'h11111111111'11'1111111111°101,,a,,/71(Atigg0410004104/joiti 1,1111 ilhoolisol?1,0110,111101111101 <br /> NH 111,11111111111111,101111111,111,111,1111,11101111,111, 1,111 1111,111111111l11111111,0011111111111111111110101011111101111111, <br /> 4. Program Activity Name <br /> Program Goal <br /> Performance Measures <br /> Previous Year Program Results <br /> Current Year Estimated Results <br /> Next Year Projected Results <br /> PROGRAM INFORMATION 1/27/2017 1 :43:18 PM Page 20 of 24 <br />