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DocuSign Envelope ID: 1632E805-38D3-49DF-9836-981006B20F64 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: The Burwell School Historic. Site Visitor Services <br /> Program Primary Contact and Title: Kate Faherty <br /> Telephone Number: 919-732-7451 E-Mail, directoraburwellschool,orq <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> O Priority Area#1: safety-net services for disadvantaged residents <br /> 12 Priority Area #2: education, mentorship, and afterschool programming for <br /> youth facing a variety of challenges <br /> O 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 /> I 1 Public Housing 1 <br /> Program Category Youth Adult Elderly Disabled I . . <br /> I 1 1 Neighborhoods/Residents <br /> Education X X X 1 X X <br /> Affordable Healthcare <br /> Art Activities X X X X I X I <br /> Family Resources <br /> Jobs/Jobs Training X X X 1 X X <br /> I 1 <br /> Food 1 1 <br /> 1 <br /> Transportation <br /> Other: local history & X X X X X <br /> culture <br /> I I <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 /> • Alliance for Historic Hillsborough& Hillsborough Visitor Services: The Burwell <br /> School and the HHC are founding members and partners of the Alliance and work <br /> throughout the year with staff at the Visitor Center to carry out a variety of programs <br /> for visitors: Living History Days, School Groups, Revolutionary War History Days, <br /> Visitor Services, Walking Tours <br /> • Hillsborough Arts Council. Last Fridays, collaboration on events <br /> • Orange County Historical Museum: Living History and walking tours <br /> • CH/Orange Co. Visitors Bureau: Interagency cooperation and support, <br /> information sharing throughout the year <br /> PROGRAM INFORMATION 1/31/2017 4:15:48 PM P a y f„, 1 1 a 1 22 <br />