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DocuSign Envelope ID: DlA09OF6-2A4E-4FOB-9FB7-92FFFC9El3D2 XHIBIT A: <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> youth, students, singles, families, retirees, and people at every life stave." <br /> Carrboro Board Priorities: E. Enhance and sustain quality of life/place issues for <br /> everyone <br /> 7. Help citizens develop a human environment that promotes trust, mutual <br /> respect, acceptance, happiness and well being. (Planning) <br /> f) Who is your target population of individuals to benefit from this program and how will they <br /> be identified and connected with the program? <br /> Boomerang primarily serves youth ages 11-19 in Orange County. Please note, we continue <br /> to provide support to a small cohort of young people who are now beyond this a e_range, <br /> but who return to us after high school for support and mentorship. Youth are referred by the <br /> two school districts, juvenile justice system and other non-profits whose work supports at <br /> risk youth including Family Success Alliance and Orange County Misdemeanor Diversion <br /> Program. <br /> g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program <br /> Manager and credentials, describe training provided to volunteers, etc.) <br /> Direct Support Staff Administration <br /> Executive Director (LCSW) Executive Director <br /> Program Manager (LCSW-A) Director of Operations <br /> Program Manager (LCAS) Office Manager <br /> ATS Student Coordinator <br /> MSW Intern <br /> Direct services are provided by licensed staff with graduate degrees in Social Work or <br /> Counseling, or equivalent experience working with vulnerable youth. A part-time student <br /> coordinator and a MSW intern (UNC-Chapel Hill School of Social Work) assist direct <br /> support staff for the Alternative to Suspension program. Licensed staff participates in <br /> Continuing Education throughout the year to keep licenses in good standing. In addition, <br /> Boomerang has three interns from the UNC-CH Bonner Leaders Program who help with <br /> student supervision, 1:1 tutoring, and program development and evaluation, among other <br /> duties. <br /> All staff members, including our MSW Intern, participate in an annual 2-day training retreat <br /> before the start of a new school year conducted by the Executive Director. All volunteers <br /> participate in a half-day orientation. <br /> All staff, interns and volunteers carefully review and sign Boomerang's Code of Conduct, <br /> Child Safety Policy and Confidentiality Agreement, and go through a comprehensive <br /> background check. <br /> h) Describe the specific period over which the activities will be carried out and include an <br /> implementation timeline. <br /> Activities will be carried out from July 1, 2018 to June 30, 2019. <br /> PROGRAM INFORMATION P a g e 12 of 2 0 <br />