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DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each p <br />Program Name: Burwell School Historic Site Visitor Services and Accessibility <br />Program Primary Contact and Title: Kate Faherty, Executive Director <br />Telephone Number: 919 732 7451 <br />E -Mail: Director (Mburwellschool,or <br />a) Indicate the type of Human Service Needs Priority, if program applicable: <br />❑ Priority Area #1: safety -net services for disadvantaged residents <br />X❑ 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 Youth Adult Elderly Disabled Public Housing <br />Affordable Housin Neighborhoods /Residents <br />Affordable Healthcare <br />Education X X x <br />Family Resources <br />Jobs /Jobs Trainin <br />Food <br />Trans portation <br />Other: Please specify <br />cj 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 />• Orange county /Chapel Hill Carrboro Visitor Bureau <br />• Hillsborough Visitor Center <br />• Alliance for Historic Hillsborough <br />• Town of Hillsborough Tourism Program <br />• Hillsborough Chamber of Commerce <br />• Hillsborough /Orange County Historical Museum <br />• Orange Co. Library <br />• NC Dept. of Natural and Cultural Resources <br />• Office of the Governor, Boards and Commissions <br />PROGRAM INFORMATION 1123/2418 12:09 :02 PM Page 14 of 27 <br />