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<br />PROGRAM INFORMATION 1/18/2018 7:54:45 PM Page 25 of 29 <br />p) Program Budget <br /> <br />1. Submit your program budget. You may complete the provided template <br />(separate xls file) or you may submit your own budget file (as long as it contains <br />the same information, in the same format, as requested in the provided <br />template). THIS IS INCLUDED WITH OUR ATTACHMENTS. <br /> <br />Program Budgets are required to define budget amounts for the previous <br />program year, current program year, and next program year for the <br />following categories: <br /> <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 <br />here) <br />o Other Government Grants <br /> Triangle United Way <br /> State Government <br /> Federal Government (CDBG/HOME/etc.) <br /> Private Foundation Grants <br />o Other Revenue <br />• Expenditures <br />o Compensation <br />o Rent & Utilities <br />o Supplies & Equipment <br />o Travel & Training <br />o Other Expenses <br /> <br />2. Program Budget Detail – Provide description of “other” budget items, not <br />defined. Other budget items include fundraising costs; agency insurance; <br />background checks; and membership fees to our national database management <br />system. <br /> <br /> <br /> <br />3. This program budget represents what percent of the agency budget? 79% <br /> <br /> <br /> <br /> <br />Exhibit A: <br />Provider's Outside Agency Application <br />DocuSign Envelope ID: 1381F24A-F27B-438F-AC45-7A16015EA606