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DocuSign Envelope ID: C47D73DC -CC50- 4723 - 8253- AE01785E7FAA <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: The ArtsCenter — Youth Education Programs <br />Program Primary Contact and Title: Fleming Samuels, Development Director <br />Telephone Number: 919 - 929 -2787 x 213 <br />E -Mail: fsamuels(,@-artscenterlive.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 />x <br />x <br />x <br />x <br />x <br />Family Resources <br />Jobs /Jobs Training <br />x <br />Food <br />Transportation <br />Other: Please specify <br />_Arts Exhibits & <br />Performances <br />x <br />x <br />x <br />x <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) to <br />be funded. For each, briefly describe the coordinated /collaborative efforts. <br />• Chapel Hill Carrboro City Schools (Youth programs planning and participants) <br />• Orange Co. Schools (Youth programs planning and participants) <br />• Orange Co Human Services (Youth programs planning and funder) <br />• Chapel Hill - Carrboro PTA (Youth programs planning and funder) <br />• OCAC (Youth programs and theater funder) <br />• NC Botanical Garden (ArtSchool collaboration) <br />• Triangle Weavers (Elf Fair Collaboration) <br />• Town of Carrboro ( Carrboro Music Festival, Carrboro Film Festival, Recs and <br />Parks) <br />• Town of Chapel Hill (Overall funder) <br />• Second Family Works (Youth job training) <br />• Apple Intern, UNC Chapel Hill (ArtsCamps) <br />PROGRAM INFORMATION 1/23/2018 1:53:53 PM �.i _- 0 <br />