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DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Rental Property Management <br />Program Primary Contact and Title: LaTanya Davis,. Property Manager <br />Telephone Number: 919 -967 -8779 E -Mail: latan ,LCct��empowermentinc- nc.orq <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 />X <br />X <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 />Provide Housing and counseling for individuals that come through their programs in <br />collaboration with: <br />DSS Public Housing Justice United <br />Rapid Rehousing CEF Cardinal Innovations <br />Housing Choice Community Home Trust CHC /Orange School Sys <br />Family Success Alliance Freedom House UNC Horizons <br />Oxford House UNC SoM Department of Psychiatry <br />2. We work closely with the following agencies to provide Emergency funding sources to <br />prevent evictions and utility disconnections: <br />The Interfaith Council, Home Start, Local Churches, JOCCA, M.O.M.Utility Fund, <br />DSS <br />3. Collaborate to find resources for financial planning to ensure property budgeting and to <br />provide emergency financial assistance when needed: <br />Community Empowerment Fund, Reid Consulting Services, Compass Center <br />Program Description (3 pages OR LESS) <br />Please provide the following information about the proposed program: <br />d) Summarize the program services proposed and how the program will address a <br />PROGRAM INFORMATION 1/2212018 3:21:37 PM P a g e 1 3 o f 2 ? <br />