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DocuSign Envelope ID: 07FEE1A8- E83F- 44CF- 99C4- 61A6E4C39BD2 <br />EXHIBIT A - PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Adaptive Technology Training/ Career Development <br />Program Primary Contact and Title: Dr. Tim <br />Telephone Number: 919 - 245 -4337 <br />Miles. Executive Director <br />E -Mail: timothy.miles(a_triangledac.org <br />a) Indicate the type of Human Service Needs Priority, if program applicable: <br />X❑ 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 <br />Youth <br />Adult <br />Elderly <br />Disabled <br />Public Housing <br />Neighborhoods /Residents <br />Affordable Housing <br />X <br />X <br />X <br />Affordable Healthcare <br />Education <br />X <br />X <br />X <br />X <br />Family Resources <br />Jobs /Jobs Training <br />X <br />X <br />X <br />X <br />Food <br />Transportation <br />X <br />X <br />X <br />Other: <br />Special Technology <br />X <br />X <br />X <br />Training <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 />• The Orange County Disability Awareness Council training programs are being <br />developed and implemented with the collaboration of: <br />• Team ing4Technologies, the United Way <br />• NC ADA Network <br />• UNC Apples Interns, High School Service - Learning, UNC PA Interns <br />• Various Orange County offices: OC Libraries, Adult Social Services, etc. <br />• NC Central Food Bank <br />• OC Senior Centers <br />o S.H.I.P. <br />• Triangle Transit, and area transit agencies <br />• Various Chapel Hill, Carrboro offices <br />• Volunteer Center of Durham <br />• We invite any other social agencies that desire training or consulting concerning <br />implementation of the ADA and customer service to people with disabilities. <br />PROGRAM INFORMATION 2/9/2017 4:31:06 PM Page 11 of 22 <br />