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DocuSign Envelope ID:0E0892A5-AB8C-4E61-8B53-2125B8922B1C XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Community Connections <br /> Program Primary Contact and Title: Rose Cuomo, Outreach Coordinator <br /> Telephone Number: 919.933.1455 E-Mail: Cuomo kidzuchildrensmuseum.orq <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> ❑ Priority Area #1: safety-net services for disadvantaged residents <br /> ® 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 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 Youth Adult Elderly Disabled Public Housing <br /> Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X X X <br /> Family Resources X X X <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Please specify <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 /> Since its inception in 2006, Kidzu has collaborated with hundreds of community partners <br /> including local title one schools, social service agencies, non-profits, community groups <br /> and individuals. For the "Community Connections" program Kidzu will strengthen both <br /> Outreach and Access programs including the following partners: <br /> • Cedar Grove Community Center <br /> • Fairview Child and Family Center <br /> • Orange County Partnership for Young Children (OCPYC) <br /> • New Hope Elementary School <br /> • Family Success Alliance <br /> • Ella Baker Women's Center for Leadership and Community Activism <br /> PROGRAM INFORMATION 2/9/2017 1:27:17 PM Pago 13 f 30 <br />