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DocuSign Envelope ID: 2F546B53- F2D1- 407D- A1C7- 26EB823DOFFD <br />ff) Program Budget <br />5. Submit your program budget. You may complete the provided template (separate xls <br />fife) or you may submit your own budget fife (as long as it contains the same information, <br />in the same format, as requested in the provided template). <br />Program Budgets are required to define budget amounts for the previous program <br />year, current program year, and next program year for the following categories; <br />• Revenues <br />• Private Donations <br />• Program Generated Revenue <br />o Local Government Grants <br />• Carrboro Human Services <br />• Carrboro Other <br />• Chapel Hill Human Services <br />• Chapel Hill Other (DO NOT include CDBG funding here) <br />• Orange County Human Services <br />• Orange County Other (DO NOT Include HOME funding here) <br />• Other Government Grants <br />• Triangle United Way <br />• State Government <br />• Federal Government (CDBG /HOMEfetc.) <br />• Private l=oundabon Grants <br />• Other Revenue <br />• Expenditures, <br />o Compensation <br />o Rent & Utilities <br />o Supplies & Equipment <br />a Travel & Training <br />o Other Expenses <br />6. Program Budget Detail — Provide description of "other" budget ltsms, not defined. <br />7. This program budget represents what percent of the agency budget? 0.05% <br />8. COST PER INDIVIDUAL <br />This Cost per Individual must reflect the total program budget divided by the total number of <br />program individuals in this application. <br />PROGRAM! INFORMATION 112212018 12:44:36 PM Page 26 of 27 <br />Total Cost of Program <br />$0 <br />$0 <br />$4780 <br />Total # of Individuals <br />0 <br />0 <br />24 <br />Cost Per Individual <br />0 <br />0 <br />$199.16 <br />PROGRAM! INFORMATION 112212018 12:44:36 PM Page 26 of 27 <br />