Orange County NC Website
Browse       Search
DocuSign Envelope ID: C2E9E60D-5370-4D81-B634-C12E6C6B9DB9 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Additional Program Information <br /> I) Target Population <br /> Complete the following tables, with numbers (not percentages) of individuals served and to be <br /> served, to the best of your ability, <br /> Program Target Population Demographics <br /> Actual Estimated Projected <br /> 2015-16 2016-17 2017-18 <br /> Gender <br /> Male 18 15 15 <br /> Female 12 15 15 <br /> Total 30 30 30 <br /> Ethnicity <br /> African-American 9 10 10 <br /> American Indian or Alaska Native <br /> Asian 3 4 4 <br /> Caucasian 10 8 8 <br /> Native Hawaiian or other Pacific Islander <br /> Other: specify 8 8 8 <br /> Total 30 30 30 <br /> Of the above, how many Hispanic/Latino 8 8 8 <br /> Of the above, how many non-Hispanic/Latino 22 22 22 <br /> Total 30 30 30 <br /> Age <br /> 0-5 years <br /> 6-18 years 30 30 30 <br /> 19-50 years <br /> 51+ years <br /> - <br /> Total 30 30 30 <br /> Geographic Location <br /> Alamance County <br /> Chatham County <br /> Durham County <br /> Wake County <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 6 6 6 <br /> Town of Chapel Hill (Non-Public Housing) 6 7 7 <br /> Town of Carrboro 10 11, 11 <br /> Town of Hillsborough <br /> City of Mebane (Orange County) <br /> Orange County (Outside Municipalities) 8 6 6 <br /> Total 30 30 30 <br /> PROGRAM INFORMATION 1/31/2017 11:45:20 AM Page 1 3 of 20 <br />