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DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Program Target Population Demographics <br />Actual Estimated Projected <br />2016 -17 2017 -18 2018 -19 <br />Gender <br />Male 45% 45% 45% <br />Female 55% 550 55% <br />Total 100% 100. 100 °la <br />Ethnicity <br />African - American <br />American Indian or Alaska Dative <br />Asian <br />Caucasian <br />Dative Hawaiian or other Pacific Islander <br />Other: specify <br />Total <br />Of the above, how many Hispanic /Latino Unknown Unknown unknown <br />Of the above, how many non- HispaniclLatino Unknown Unknown unknown <br />Total 5500 7000 8000 <br />Age <br />0 -5 years <br />6 -18 years <br />19 -50 years <br />51+ years <br />Total <br />Geographic Location <br />Alamance County <br />225 <br />400 <br />225 <br />3500 <br />225 <br />Chatham County <br />300 <br />500 <br />300 <br />1000 <br />300 <br />Durham County <br />300 <br />300 <br />300 <br />Wake County <br />0 <br />275 <br />275 <br />275 <br />range County Breakdown <br />Chapel Hill Public Housing <br />Town of Chapel Hill (Non- Public Housing) <br />Town of Carrboro <br />Town of Hillsborough <br />City of Mebane (Orange County) <br />Orange County (Outside Municipalities) <br />400 <br />400 <br />400 <br />3500 <br />3500 <br />3500 <br />540 <br />500 <br />500 <br />1000 <br />1000 <br />1000 <br />Total 6500 7000 7000 <br />PROGRAM INFORMATION 1/2312018 12:09 :02 PM Page 22 of 27 <br />