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DocuSign Envelope ID: C4A8ABA9- 961E- 4297- 82F0- 5B1739260CFF <br />p) Program Budget <br />1. Submit your program budget. You may complete the provided template (separate As <br />file) or you may submit your own budget file (as long as it contains the same information, <br />in the same format, as requested in the provided template). <br />Program Budgets are required to define budget amounts for the previous program <br />year, current program year, and next program year for the following categories: <br />Revenues <br />o Private Donations <br />o Program Generated Revenue <br />o Local Government Grants <br />• Carrboro Human Services <br />• Carrboro Other <br />■ Chapel Hill Human Services <br />■ Chapel Hill Other (DO NOT include CDBG funding here) <br />Orange County Human Services <br />• Orange County Other (DO NOT Include HOME funding here) <br />0 Other Government Grants <br />■ Triangle United Way <br />• State Government <br />■ Federal Government (CDBGIHOME /etc -) <br />■ Private Foundation Grants <br />0 Other Revenue <br />Expenditures <br />o Compensation <br />o Rent & Utilities <br />o Supplies & Equipment <br />o Travel & Training <br />t) Other Expenses <br />2. Program Budget Detail — Provide description of "other" budget items, not defined. <br />3. This program budget represents what percent of the agency budget? 5% <br />4. COST PER INDIVIDUAL <br />This Cost per Individual must reflect the total program budget divided by the total number of <br />program individuals in this application. <br />PROGRAM INFORMATION 2112/2018 7:53:03 PM Page 2 5 of 28 <br />Actual 2016 -17 <br />Estimated 2017 -18 <br />Projected 2018 -19 <br />Total Cost of Program <br />20,000 <br />Total # of Individuals <br />1,600 <br />12.50 <br />Cost Per Individual <br />PROGRAM INFORMATION 2112/2018 7:53:03 PM Page 2 5 of 28 <br />