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DocuSign Envelope ID: 7A9252AF- OE3A- 47EE- A4F6- 2A3D9DF527FF <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Promise of Home: Emergency Repairs & Long -term Neighbor Retention Sport <br />Program Primary Contact and Title: Hudson Vaughan, Senior Director <br />Telephone Number: 919- 960 -1670 E -Mail: Hudson @jacksoncenter.info <br />a) Indicate the type of Human Service Needs Priority, if program applicable: <br />® 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 />X <br />X <br />_ <br />Affordable Healthcare <br />Education <br />X <br />X <br />X <br />X <br />Family Resources <br />Jobs /Jobs Training <br />Food <br />Transportation <br />Other: Please specify <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 />All of our work is essentially collaborative especially because our mission is so uniquely place - <br />based. We partner with over 35 agencies in the area for different aspects of our work. Some of our <br />primary partnerships for this program include: <br />• Habitat for Humanity and Self -Help: Our core home - repair partners. This group meets every <br />month to complete joint reviews of applications and coordinate plans to best meet the needs of <br />home repair applicants. <br />• Fix -a -Home, Rebuilding Together, JOCCA, Orange County Urgent Repair, OWASA: Referral <br />partners for home repairs, including for households outside of Northside, Pine Knolls, <br />Lloyd /Broad, and Tin Top. <br />• Black Law Student Association, UNC Pro Bono Clinic, CCLA, Center for Civil Rights, LegalAid: <br />Organizations with whom we partner for the free wills drafting clinics and legal advocacy for <br />neighbors. <br />• Self -Help, the Towns of Chapel Hill & Carrboro, UNC - Chapel Hill, and all local affordable <br />housing agencies: implementation partners for the Northside Neighborhood Initiative. <br />PROGRAM INFORMATION 1/23/2018 2:58:40 PM Page 2 of 10 <br />