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DocuSign Envelope ID: D068E7B0- D869- 43F4- B35C- 428F10E3BDC1 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Mediation — in court and in the community <br />Program Primary Contact and Title: Jenifer Yarnelle, Mediation Coordinator <br />Telephone Number: 919 929 -8800 <br />E -Mail: jarnelle(a)disputesettlement.org <br />a) Indicate the type of Human Service Needs Priority, if program applicable: <br />X❑ Priority Area #1: safety -net services for disadvantaged residents <br />❑ Priority Area #2: education, mentorship, and afterschool programming for <br />youth facing a variety of challenges <br />❑ Priority Area #3: programs aimed at improving health and nutrition of needy residents <br />b) Indicate the type of program for which you are requesting funding <br />(Check all that apply to this program) <br />Program Category <br />Youth <br />Adult <br />Elderly <br />Disabled <br />Public Housing <br />Neighborhoods /Residents <br />Affordable Housing <br />Affordable Healthcare <br />Education <br />Family Resources <br />Jobs /Jobs Training <br />Food <br />Transportation <br />Other: Please specify <br />conflict resolution and <br />mediation <br />x <br />x <br />x <br />x <br />x <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 Program(s) <br />to be funded. For each, briefly describe the coordinated /collaborative efforts. <br />We receive case referrals from these entities, among others: <br />Orange County Criminal District Court; <br />Orange County Civil District Court (50 -C cases) <br />Orange County Magistrates; <br />Orange County Small Claims Court; <br />Orange County Animal Control; <br />Orange County Senior Centers; <br />Orange County Clerk of Court; <br />Orange County Department on Aging: <br />Homeowners' Associations (HOAs): <br />Chapel Hill Police Department Crisis Unit; <br />PROGRAM INFORMATION 1/22/2018 4:11:17 PM Page 15 of 27 <br />