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DocuSign Envelope ID: 42882613- 58E8 -4BA1- 9376- A348D7FC56CA <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />2. Program Budget Detail — Provide description of "other" budget items, not defined. <br />Other budget items include event revenues and expenses, fees and grants associated with <br />our affiliation with Boys & Girls Clubs of America, and professional fees (audit and <br />consulting). <br />3. This program budget represents what percent of the agency budget? -L-216 <br />4. COST PER INDIVIDUAL <br />This Cost per Individual must reflect the total program budget divided by the total number of program <br />individuals in this application. <br />'Agency management salaries are not included in the program budget, resulting in a decrease in the cost of the program. <br />Actual 2018 -17 <br />Estimated 2017 -18 <br />Projected 2018 -19 <br />Total Cost of Program <br />$130,499 <br />$91,000 <br />$86,152 <br />Total # of Individuals <br />40 <br />70 <br />75 <br />Cost Per Individual <br />$3,262 <br />$1,300 <br />$1,148 <br />'Agency management salaries are not included in the program budget, resulting in a decrease in the cost of the program. <br />