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DocuSign Envelope ID:72266CE5-DF5A-471E-B671-CC65C8960691 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Rental Property Management <br /> Program Primary Contact and Title: LaTanya Davis, Property Manager <br /> Telephone Number: 919-967-8779 E-Mail: latanyaempowermentinc-nc.orq <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> Priority Area #1: safety-net services for disadvantaged residents <br /> E 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 /> Public Housing <br /> Program Category Youth Adult Elderly Disabled . . <br /> Neighborhoods/Residents <br /> Affordable Housing X X X X <br /> Affordable Healthcare <br /> Education <br /> (Counseling) X X X X <br /> Family Resources <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Please specify <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 /> 1. Provide Housing and counseling for individuals that come through their programs <br /> in collaboration with: <br /> Department of Social Services <br /> Rapid Rehousing Community EmPOWERment Fund <br /> Housing Choice Community Home Trust <br /> Housing for New Hope Freedom House <br /> Oxford House UNC Horizons <br /> Cardinal Innovations Health Care Solutions <br /> UNC School of Medicine Department of Psychiatry <br /> PROGRAM INFORMATION 1/25/2017 4:42:59 PM P a g a 1 $ a f 22 <br />