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DocuSign Envelope ID:A13A145D-D67A-4FF7-ABA9-312E380D8DD9 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Volunteers for Youth <br /> Program Primary Contact and Title: Susan Worley, Executive Director <br /> Telephone Number: 919-967-4511 E-Mail: susan@volunteersforyouth.org <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> ❑ Priority Area #1: safety-net services for disadvantaged residents <br /> ® Priority Area #2: education, mentorship, and afterschool programming for <br /> youth facing a variety of challenges <br /> ❑ 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 <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Please specify <br /> Mentoring, community <br /> service, teen court <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 /> • Orange County Office of Juvenile Justice —VFY staff work closely with court <br /> counselors to monitor progress of youth in our program, sending monthly progress <br /> reports on individual youth to the court counselors, attending court planning <br /> meetings and sessions of juvenile court, and communicating with them frequently <br /> via phone, email, and in person conversations <br /> • A network of community service worksites including Hope Garden, Anathoth <br /> Garden, Camp Chestnut Ridge, and Boomerang — VFY staff recruit volunteers at <br /> local nonprofits who supervise court-ordered community service work of youth at <br /> their organization. VFY staff check in with the work site coordinators regularly to <br /> monitor the youth's hours and conduct. <br /> • UNC's SMART Project— In coordination with the Buckley Public Service Scholars <br /> Program at the UNC Center for Public Service, VFY recruits, screens, trains, and <br /> PROGRAM INFORMATION 2/8/2017 10:03:24 AM page I 2 00 22 <br />