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DocuSign Envelope ID: 2AC82140 -8F6C- 4125 - 8743- OB8594E61466 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Weekend Meal Backpack Program <br />Program Primary Contact and Title: Laura Dille <br />Telephone Number: (919)636 -4860 E -Mail: Idille(a)tablenc.org <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 />Affordable Healthcare <br />Education <br />Family Resources <br />Jobs /Jobs Training <br />Food <br />X <br />Transportation <br />Other: Please specify <br />Nutrition Education <br />X <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 />• McDougle Elementary School: Provide information /support to feed attending kids. <br />• Frank Porter Graham Elementary School: Provide information /support to feed <br />attending kids. <br />• Ephesus Elementary School: Provide information /support to feed attending kids. <br />• Estes Hills Elementary School: Provide information /support to feed attending kids. <br />• Mary Scroggs Elementary School: Provide information /support to feed attending <br />kids. <br />• Rashkis Elementary School: Provide information /support to feed attending kids. <br />• Seawell Elementary School: Provide information /support to feed attending kids. <br />• Carrboro Elementary School: Provide information /support to feed attending kids. <br />• McDougle Middle School: Provide information /support to feed attending kids. <br />• Culbreth Middle School: Provide information /support to feed attending kids. <br />PROGRAM INFORMATION 1/23/2018 3:44:19 PM <br />