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DocuSign Envelope ID:3457204A-7765-4E36-8B42-227F6F673AF6 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 1. YOLD <br /> Additional Program Information <br /> k) Target Population <br /> Complete the following tables, with numbers (not percentages) of individuals served and to be <br /> served, to the best of y our ability, <br /> Program Target Population Demographics <br /> Actual Estimated Projected <br /> 2015-16 2016-17 2017-18 <br /> Gender <br /> Male 2 4 <br /> Female 2 6 <br /> Transgender 3 5 <br /> Total 7 15 <br /> Ethnicity <br /> African-American 2 5 <br /> American Indian or Alaska Native 0 1 <br /> Asian 1 2 <br /> Caucasian 3 4 <br /> Native Hawaiian or other Pacific Islander 0 0 <br /> Other: specify 1 3 <br /> Total 7 15 <br /> Of the above, how many Hispanic/Latino 1 3 <br /> Of the above, how many non-Hispanic/Latino 6 12 <br /> Total 7 15 <br /> Age <br /> 0-5 years 0 0 <br /> 6-18 years 7 14 <br /> 19-50 years 0 1 <br /> 51+ years 0 0 <br /> Total 7 15 <br /> Geographic Location <br /> Alamance County 1 1 <br /> Chatham County 0 0 <br /> Durham County 1 1 <br /> Wake County 0 0 <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 1 2 <br /> Town of Chapel Hill (Non-Public Housing) 1 4 <br /> Town of Carrboro 2 4 <br /> Town of Hillsborough 0 1 <br /> City of Mebane (Orange County) 1 1 <br /> Orange County(Outside Municipalities) 0 1 <br /> Total 7 15 <br /> PROGRAM INFORMATION 1/31/2017 12:37:26 PM Page 17 of 45 <br />