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DocuSign Envelope ID:64D61581-25C0-4408-84C2-991109E2DF4C XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Additional Proclram 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 150 228 230 <br /> Female 142 136 145 <br /> Total 292 364 375 <br /> Ethnicity <br /> African-American 156 228 230 <br /> American Indian or Alaska Native 5 7 2 <br /> Asian 1 2 1 <br /> Caucasian 121 116 130 <br /> Native Hawaiian or other Pacific Islander 0 0 0 <br /> Other: specify Clients identified as Multi-racial 9 11 12 <br /> Total 292 364 375 <br /> Of the above, how many Hispanic/Latino 1 2 2 <br /> Of the above, how many non-Hispanic/Latino 291 362 373 <br /> Total 292 364 375 <br /> Age <br /> 0-5 years 24 40 42 <br /> 6-18 years 26 32 33 <br /> 19-50 years 111 174 180 <br /> 51+years 131 118 120 <br /> Total 292 364 375 <br /> Geographic Location <br /> Alamance County 11 8 10 <br /> Chatham County 3 14 15 <br /> Durham County 55 70 75 <br /> Wake County 10 48 55 <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 0 <br /> Town of Chapel Hill (Non-Public Housing) 118 124 130 <br /> Town of Carrboro 10 18 25 <br /> Town of Hillsborough 0 2 <br /> City of Mebane (Orange County) 0 1 <br /> Orange County(Outside Municipalities) 39 24 30 <br /> PROGRAM INFORMATION 1/31/2017 11:43:55 AM P g ' "'/ of 35 <br />