Orange County NC Website
Browse       Search
DocuSign Envelope ID: COBB49A6 -D1 E9- 42DE- 8E8D- 7583E683E1E2 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Of the above, how many HispaniclLatino <br />Of the above, how many non-Hispanic/Latino <br />Total 7200 7800 7900 <br />Age <br />Geographic Location <br />0 -5 years <br />6 -18 years <br />19 -50 years <br />51+ years <br />Total <br />Alamance County <br />Chatham County <br />Durham County <br />Wake County <br />Orange 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 />Work Statement <br />Total 1 7200 7800 1 7900 <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 9 Program <br />Activity, which should be SMART (�pecific, Measurable, Achievable, Relevant, and Time - <br />bound. Click on SMART Goals to learn more. <br />• Program Activities should outline major activities the agency implements to accomplish <br />its program goals. (i.e. Deliver meals to elderlyldisabled residents.) <br />• Program Goal should explain what the program is trying to achieve /accomplish. Goals <br />are statements about what the program should accomplish. (i.e. Deliver 900 meals per <br />day, Monday - Friday.) <br />• Performance Measures describe how you will evaluate the degree in which you <br />achieved 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 <br />of 905 meals per day.) <br />Work Statement Chart for Program: Living Wage Certification Program <br />PROGRAM INFORMATION <br />1/2112018 12:07:58 PM Page 14 of 17 <br />