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DocuSign Envelope ID: El 573D55-1 DC0 -4F4C- 9784- 749E3E95640B <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />1. A Spring Fundraiser - Dining for Dollars, that currently brings in approximately <br />$50,000 per year, <br />2. A Fall Fundraiser - Airline Ticket Raffle that can raise a total of $10,000, <br />3. March Madness — a restaurant eat -out night that supports CHCMOW, <br />4. And an expanded annual fund campaign that reaches out to an increasing <br />number of potential donors each year. <br />Income Sources <br />2% <br />6% <br />7% 0 Individuals <br />31'9�0� <br />0 Events <br />19 Grants <br />— Program fees <br />United Way <br />Corporations <br />18% <br />Congregations <br />This past year CHCMOW received a significant one -time donation that was set aside to <br />help pay for expanded space to meet the growing demands for our services. In mid to <br />late 2018 CHCMOW will be moving to St Thomas More in the new space that is <br />currently Aldersgate Church. In support of this move a significant amount was allocated <br />toward STM's campaign to help purchase and renovate the space that we will then be <br />able to use free of charge. Surpluses accrued over 2016 and 2017 were part of long <br />range planning to expand the professional capacity of CHCMOW as well as our office <br />and distribution space so that we could continue to meet the growing need for our <br />services. The deficit projected in 2018 encompasses the expenses associated with our <br />move as well as the increased demand as projected by current demographic <br />information. <br />iv. What is your agency's fiscal year? January 1 through December 31 <br />V. (Example: July 1, 2016 through June 30, 2017) <br />Agency Information 1/22/2018 9:22:00 AM Page 14 of 26 <br />