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<br />PROGRAM INFORMATION 11/13/2017 11:44:58 AM Page 13 of 20 <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> <br />Program Name: <br /> <br />Program Primary Contact and Title: <br /> <br />Telephone Number: E-Mail: <br /> <br /> <br />a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> <br /> Priority Area #1: safety-net services for disadvantaged residents <br /> <br /> Priority Area #2: education, mentorship, and afterschool programming for <br />youth facing a variety of challenges <br /> <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 /> <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 /> <br /> <br />Program Description (3 pages OR LESS) <br /> <br />Please provide the following information about the proposed program: <br /> <br />d) Summarize the program services proposed and how the program will address a <br />Town/County priority/goal? <br /> <br /> <br />e) Describe the community need or problem to be addressed in relation to the Chapel Hill <br />Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of <br />Chapel Hill Council Goals, Carrboro Board Priorities, or other community priorities (i.e. <br />Council/Board Goals). Reference local data (using the provided links, i.e. Chapel Hill <br />Human Services Needs Assessment) to support the need for this program. <br />Program Category Youth Adult Elderly Disabled Public Housing <br />Neighborhoods/Residents <br />Affordable Housing <br />Affordable Healthcare <br />Education <br />Family Resources <br />Jobs/Jobs Training <br />Food <br />Transportation <br />Other: Please specify <br />_________________ <br /> <br />14