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DocuSign Envelope ID: C2E9E60D-5370-4D81-B634-C12E6C6B9DB9 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Young Warriors Program <br /> Program Primary Contact and Title: Nathan Ligo— Executive Director <br /> Telephone Number: 919-923-6915 E-Mail: nligoahotmail.com <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 /> N <br /> ._: erghborhoods/Residerlts" <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education <br /> Family Resources <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Yes <br /> After-School Activities <br /> Sports and Arts <br /> Activities <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 /> We currently accept referrals from many agencies serving disadvantaged youth. They have <br /> included but are not limited to: <br /> • The Department of Juvenile Justice (court-involved youth) <br /> • Carolina Outreach (mental health) <br /> • Big Brothers and Big Sisters of the Carolina's (mentoring) <br /> • Exchange Club Family Center <br /> • Carolina Outreach <br /> • El Centro Hispano <br /> • Chapel Hill Refugee center <br /> • We continue to be popular among mental health agencies. <br /> • Law enforcement and school social workers can also make referrals. <br /> PROGRAM INFORMATION 1/31/2017 11:45:20 AM Page 9 of 2 0 <br />