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DocuSign Envelope ID: E85EF868-A4BB-49ED-96E1-165F3DADBAE4 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Community Education <br /> Program Primary Contact and Title: Rachel Valentine, Community Education Director <br /> Telephone Number: 919-968-4647 E-Mail: rvalentineocrcc.org <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> El Priority Area #1: safety-net services for disadvantaged residents <br /> A Priority Area #2: education, mentorship, and afterschool programming for <br /> youth facing a variety of challenges <br /> 14 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 /> Public Housing <br /> Program Category Youth Adult Elderly Disabled I <br /> Neighborhoods/Residents <br /> Affordable Housing EMI <br /> Affordable Healthcare <br /> Education X X I X I X X <br /> Famil Resources <br /> Jobs/Jobs Training .1.1111 <br /> Food <br /> Trans•ortation <br /> Other: Please specify X X X X <br /> Violence Prevention <br /> c) 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 Program(s) <br /> to be funded, For each, briefly describe the coordinated/collaborative efforts. <br /> • Orange County Schools and Chapel Hill-Carrboro City Schools: The OCRCC maintains an <br /> annual Memorandum of Agreement (MOA) with both OCS and CHCCS outlining <br /> responsibilities of both parties for program delivery, parent communication, and follow-up <br /> protocol with students who raise concerns during or immediately following a program. <br /> • Compass Center for Women & Families: The OCRCC collaborates with Compass to <br /> provide joint programming in the Start Strong program. The OCI7CC provides 7" and 9" <br /> grade programs, and Compass provides 6' and 8" grade programs. We work together to <br /> ensure content and evaluation coherence. <br /> • Department of Social Services: The OCRCC regularly refers families of students who raise <br /> concerns during classroom programs to the Child Protective Services division of DSS for <br /> follow-up services and intervention if needed. <br /> DO NOT SU:MIT THIS PAGE 1/30/2017 5:14:05 PM P 1 1 27 <br />