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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: Youth and Teen Nature Day Camp <br /> Program Primary Contact and Title: Karen McCall, Education Director <br /> Telephone Number: 919-489-0900 E-Mail: karenm.pwc( gmail.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 <br /> facing a 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 /> Program Category Yout Adult Elderl Disabled Public Housing <br /> h y Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X <br /> Family Resources <br /> Jobs/Jobs Training X X <br /> Food <br /> Transportation X <br /> Other: Please specify <br /> Outdoor activities - <br /> nature 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 /> • Orange County Parks and Rec - We have continued our partnership this year to run 8 <br /> camps this summer, one in spring 2017 and one in fall 2018 at Blackwood Farm Park <br /> • Send a Kid to Camp through the Triangle Community Foundation - awards us funding to <br /> offer scholarships to families in need <br /> • Global Giving Foundation - we have a "Send 70 Kids to Nature Camp" project through <br /> this foundation helping Piedmont Wildlife Center raise needed funds to provide <br /> scholarships. <br /> 1/12/2017 2:56:42 PM Page 20 •f 29 <br />