Orange County NC Website
Browse       Search
DocuSign Envelope ID:80528E57-64B2-4BCE-A558-776533408604 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Preservation and conservation <br /> Program Primary Contact and Title: Candace Midgett, executive director <br /> Telephone Number: (919) 732-2201 E-Mail: director @orangenchistory.org <br /> • Indicate the type of Human Service Needs Priority, if program applicable: <br /> ❑ Priority Area #1: safety-net services for disadvantaged residents <br /> X 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 <br /> residents <br /> • 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 /> Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable <br /> Healthcare <br /> Education X X X X X <br /> Family Resources <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Please <br /> specify <br /> • 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 <br /> Program(s) to be funded. For each, briefly describe the coordinated/collaborative <br /> efforts. <br /> • <br /> Program Description (3 pages OR LESS) <br /> Please provide the following information about the proposed program: <br /> PROGRAM INFORMATION 2/9/2017 1:10:02 PM 1 o 2 9 If 8 <br />