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DocuSign Envelope ID: FCA96EA6-6080-4E8E-8EFF-B03ECA597827 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Applications are accepted once a year and reviewed by the Town's Human Services <br /> Advisory Board, which makes a recommendation for funding to the Town Council for final <br /> approval. <br /> For more information about the Town of Chapel Hill Human Services program, see here. <br /> Questions and submittals should be directed to: <br /> Jackie Thompson <br /> 405 Martin Luther King Jr. Blvd. <br /> Chapel Hill, NC 27514 <br /> 919-969-5081 <br /> jthompson@townofchapelhili.orq <br /> Submission: <br /> • We strongly encourage applications to be single-spaced, with 12-point anal <br /> font and normal margins. <br /> A Application: Two (2) paper copies of the application with ORIGINAL <br /> signatures must be hand delivered or mailed to Jackie Thompson, 405 <br /> Martin Luther King, Jr. Blvd., Chapel Hill, NC 27514; AND <br /> > Attachments: The application submittal must be accompanied by a flash drive <br /> with the application and all attachment files in electronic format. Any .pdf <br /> files must be accompanied by the original file format of .doc, .xls, etc. <br /> Human Services—Orange County <br /> For more information about the Orange County Human Services program, see here. <br /> Questions and submittals should be directed to: <br /> Allen Coleman <br /> PO Box 8181 <br /> Hillsborough, NC 27278 <br /> (919) 245-2151 <br /> acolemanoranqecountync.00v <br /> Submission: <br /> > Email application and ALL Attachments prior to the deadline. Any .pdf <br /> files must be accompanied by the original file format of .doc, .xls, etc. Please <br /> request a delivery receipt of email with application and attachments. <br />