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DocuSign Envelope ID: C47D73DC -CC50- 4723 - 8253- AE01785E7FAA <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Work Statement <br />o) Complete the Work Statement Chart to describe the work to be performed. <br />This chart is used to document program activities, program goals, performance measures, and <br />actual results. (Add more rows as needed) If this is a new program, you will only document the <br />projected information. Every program is required to have AT LEAST 1 Program Activity, which <br />should be SMART (,2pecific, Measurable, Achievable, Relevant, and _Time-bound. Click on <br />SMART Goals to learn more. <br />• Program Activities should outline major activities the agency implements to accomplish its <br />program goals. (i.e. Deliver meals to elderly /disabled residents.) <br />• Program Goal should explain what the program is trying to achieve /accomplish. Goals are <br />statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br />Monday- Friday.) <br />• Performance Measures describe how you will evaluate the degree in which you achieved the <br />stated goals. (i.e. Will track the number of meals delivered each day.) <br />• Actual Program Results use program results to indicate the actual measureable achievement <br />of goals. If goals were not met, please explain. (i.e. Delivered an average of 105 meals per <br />day.) <br />Work Statement Chart for Program Youth Education Department Support <br />1. Program Activity Name <br />ArtsCamp <br />Program Goal <br />Offer 11 Weeks of camps and teen workshops <br />Performance Measures <br />ArtsCamp Catalog and Schedule <br />Previous Year Program Results <br />Offered 11 weeks of camp and teen workshops totaling 1672 class <br />units <br />Current Year Estimated Results <br />Offer 11 weeks of camp and teen workshops totaling 1650 class <br />units <br />Next Year Projected Results <br />Offer 11 weeks of camp and teen workshops through 1650 class <br />units <br />2. Program Activity Name <br />AfterSchool Arts Immersion <br />Program Goal <br />Serve 65 youth monthly through AAI and Youth ArtSchool Classes <br />Performance Measures <br />AAI and ArtSchool Registration <br />Previous Year Program Results <br />Served 65 youth monthly through AAI and Youth ArtSchool Classes <br />Current Year Estimated Results <br />Serve 70 Youth Monthly through AAI and Youth ArtSchool Classes <br />Next Year Projected Results <br />Serve 70 Youth Monthly through AAI and Youth ArtSchool Classes <br />3. Program Activity Name <br />School Shows <br />Program Goal <br />Present 55 School Shows at the ArtsCenter and in area schools that <br />enhance NC curricula <br />Performance Measures <br />School show contracts, schedule and teacher guides <br />Previous Year Program Results <br />Presented 55 school shows and received 85% positive rating <br />Current Year Estimated Results <br />Present 58 school shows and received an 87% positive rating <br />Next Year Projected Results <br />Present 60 school shows and receive 85% or better positive ratings <br />4. Program Activity Name <br />Artist in Residence <br />Program Goal <br />Offer 24 residencies to 1800 students in four Title 1 Schools <br />Performance Measures <br />Artist contracts, class records and content tests <br />Previous Year Program Results <br />Offer 16 residencies to over 1275 students <br />Current Year Estimated Results <br />Offer 24 residencies for 1800 students <br />Next Year Projected Results <br />Offer 24 residencies to 1800 students <br />PROGRAM INFORMATION 1/23/2018 1:53:53 PM Page 18 of 22 <br />