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DocuSign Envelope ID:3457204A-7765-4E36-8B42-227F6F673AF6 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 2. Youth Artists Exhibitions <br /> Work Statement <br /> m) 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 Artists Exhibition <br /> 5. Program Activity Name Planning and executing the exhibition. <br /> Program Goal Provide youth with leadership opportunities, concrete skills, <br /> and gallery experience necessary for careers in visual art. <br /> Increase visibility of youth presence and youth perspectives <br /> within the greater community. Increase confidence in <br /> expressing themselves, their thoughts, and their struggles to <br /> the public through art <br /> Performance Measures Involvement at the planning coalition level from students <br /> across CHCCS and Orange County Schools. Qualitative <br /> feedback from youth regarding what they learned and a shift <br /> in their behavior ranking for how likely they would be to submit <br /> their work to an art exhibit before and after this experience. <br /> Organizers will develop and/or supplement an ongoing list of <br /> "lessons learned" related to conducting a successful art <br /> exhibition to be used in future ears' exhibitions. <br /> Previous Year Program Results 50 art pieces were viewed by 200+ gallery attendees <br /> Current Year Estimated Results 50 art pieces will have been viewed by 300+gallery attendees <br /> Next Year Projected Results 80 art pieces will be viewed by 400 gallery attendees and <br /> youth artists will be further transformed through connections <br /> to buyers or to future art projects due to the visibility of their <br /> pieces. <br /> 6. Program Activity Name <br /> Program Goal <br /> Performance Measures <br /> Previous Year Program Results <br /> Current Year Estimated Results <br /> Next Year Projected Results <br /> DO NOT SUBMIT THIS PAGE 1/31/2017 12:37:26 PM Page 25 of 45 <br />