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PROGRAM INFORMATION 1/18/2018 7:54:45 PM Page 17 of 29 <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Community-Based and Site-Based Mentoring <br />Program Primary Contact and Title: Andie Thomas-Young, VP of Programs <br />Telephone Number: 919-850-9772 E-Mail: ayoung@bbbstri.org <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 />X 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 <br />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 <br />Program(s) to be funded. For each, briefly describe the coordinated/collaborative <br />efforts. <br /> <br />• Wake and Durham County Departments of Social Services – These DSS agencies <br />refer children to us and also serve as the legal guardian for some of our clients. <br />• North Carolina Department of Juvenile Justice – This department refers children to <br />our agency. <br />• Durham Housing Authority and the Housing Authority of Wake Counties – These <br />groups refer children to us that they determine are in need of our services. <br />• JD Lewis Community Center in Raleigh <br />Program Category Yout <br />h Adult Elderl <br />y Disabled <br />Public Housing <br />Neighborhoods/Resident <br />s <br />Affordable Housing <br />Affordable Healthcare <br />Education X <br />Family Resources X <br />Jobs/Jobs Training <br />Food <br />Transportation <br />Other: Please specify <br />____Mentoring_____ <br />_ X <br />Exhibit A: <br />Provider's Outside Agency Application <br />DocuSign Envelope ID: 1381F24A-F27B-438F-AC45-7A16015EA606