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DocuSign Envelope ID: FOFFD659- 4159- 4D4C- 82FD- FF8E51A5A7E4 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Other /Unknown 1541210 41201 1 01203 <br />Total 1 925 1 570 1 670 <br />These are unduplicated client numbers across all of the self- sufficiency programs. <br />Decrease of clients from FY 16 -17 to FY 17 -18 is due to no longer providing <br />Volunteer Income Tax Assistance program. <br />Work Statement <br />o) Complete the Work Statement Chart to describe the work to be performed. <br />This chart is used to document program activities, program goals, performance measures, <br />and actual results. (Add more rows as needed) if this is a new program, you will only <br />document the projected information. Every program is required to have AT LEAST 1 <br />Program Activity, which should be SMART (�jpecific, Measurable, Achievable, Relevant, and <br />Time- bound. Click on SMART Goals to learn more. <br />• Program Activities should outline major activities the agency implements to accomplish its <br />program goals. (i.e. Deliver meals to elderly /disabled residents.) <br />• Program Goal should explain what the program is trying to achieve /accomplish. Goals are <br />statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br />Monday- Friday.) <br />• Performance Measures describe how you will evaluate the degree in which you achieved <br />the stated goals. (i.e. Will track the number of meals delivered each day.) <br />• Actual Program Results use program results to indicate the actual measureable <br />achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of <br />105 meals per day.) <br />Work Statement Chart for Program: Self - Sufficiency Programs: Legal Information, Financial <br />Education & Career Preparedness <br />Legal Information: Provide accessible, understandable, and <br />respectful free legal information to clients who cannot afford <br />legal representation. Services include in- person <br />appointments with UNC Law students (supervised by <br />Program Goal 85% of clients will report that they are more knowled eable <br />PROGRAM INFORMATION 1122/2018 5:50:18 PM Page 3 1 of 47 <br />