BOH agenda 022416 - Laserfiche WebLink

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MAIN APPLICATION Program /Proiect Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff 1) Disclosure of Potential Conflicts of Interested must be signed m) Complete the Work Statement Chart to describe the work to be performed, and be sure to attach copies of all data collection tools that will be used to verify achievement of program goals and objectives. Describe who will be responsible for monitoring progress. Information to Complete j.) Target Population Complete the following tables to the best of your ability. Show numbers of participants and percentages, as applicable, in each category. Please indicate whether this project /program will serve: ® Persons ❑ Households ❑ Units Program: Carrboro Community Health Center Program Beneficiary Demographics Actual* Estimated* Projected ** CY2014 CY2015 2016 -17 Gender Male Female Total Of the females, how many are single - female Head of Households (Omit for Human Services) Ethnicity Age African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total 0 -5 years 6 -18 years Revised November 20, 2014 2,701 (39.9 %) 2,651 (39.4 %) See notes below 4,072 60.1% 4,065 60.1% See notes below 6,773 6,716 See notes below HS App. Only HS App. Only HS App. Only 622(9.2%) 661(9.8%) See notes below 21 (0.3 %) 21 (0.3 %) See notes below 604(8.9%) 610(9.1%) See notes below 5,260 (77.7 %) 5,175 (77.1 %) See notes below 0(0.0%) 0(0.0%) See notes below 266(39%) 249(3.7%) See notes below 6,773 6,716 See notes below 4,537 (66.9 %) 4,433 (66.0 %) See notes below 2,236 (33.1%) 2,283 (34.0 %) See notes below 6,773 6,716 See notes below 1,140 (16.8 %) 987 (14.7 %) See notes below 1,817 (26.8 %) 1,898 (28.3 %) See notes below Page 10 of 22 Pages