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DocuSign Envelope ID: 8FFCF3D9- 3AF5 -4C83- 9829- AC9D4975107C <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br />Program Name: Outreach Education <br />Program Primary Contact and Title: Stephanie Pryor, Interim Executive Director <br />Telephone Number:(919) 732 -2201 E -Mail: director @orangenchistory.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 />X 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 />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 />• For Hillsborough History Day field trips, we work with The Alliance for Historic <br />Hillsborough and Burwell School. <br />• For family workshops like Revolutionary War Living History ay, we collaborate with The <br />Alliance for Historic Hillsborough. <br />• For Last Friday Art Walk family workshop events we work with the Hillsborough Arts <br />Council. <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 />Town /County priority /goal? <br />PROGRAM INFORMATION 1/23/2018 12:14:22 PM =j a g e 2 3 cs i <br />