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DocuSign Envelope ID:A6B9A80E-25C6-439A-A77D-6C8B04CDDFE2 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: EarthKeepers Afterschool Program at Carrboro Elementary School <br /> Program Primary Contact and Title: Karen McCall, Education Director <br /> Telephone Number: 919-489-0900 E-Mail: karenm.pwc(cgmail.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 /> x Priority Area #2: education, mentorship, and afterschool programming for youth facing a <br /> 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 /> Yout Public Housing <br /> Program Category h Adult Elderly Disabled Neighborhoods/R <br /> esidents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X <br /> Family Resources <br /> Jobs/Jobs Training X <br /> Food <br /> Transportation <br /> Other: Please specify <br /> Outdoor activities - nature <br /> connection X <br /> c) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates <br /> to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly <br /> describe the coordinated/collaborative efforts. <br /> Chapel Hill Carrboro Community Schools - We ran an outdoor program at 3 of their <br /> elementary after-school programs, and held a continuing education training for teachers that <br /> provided them with tools to mentor and connect kids to nature, and assist our staff in <br /> executing the activities. The Carrboro Elementary Afterschool Manager reached out to ask if <br /> we could come back because staff and students missed us and really benefitted from our <br /> partnership. They have been using what they remember of the activities and routines we <br /> taught them, but would like more support and training. <br /> Global Giving Foundation - We have a "Help 30 students become EarthKeepers" <br /> project through this foundation which help raises funds so we can provide programming. <br /> 1/12/2017 2:56:42 PM Page 11 .f 29 <br />