Orange County NC Website
Browse       Search
DocuSign Envelope ID:3457204A-7765-4E36-8B42-227F6F673AF6 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 4. LGBTQ Youth <br /> PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: 4. LGBTQ Youth Community Building Initiatives: Fluid Revolutions, <br /> Queer Youth Drop In (In the 2017-18 program year, LGBTQ YCBI will be come under YCP's <br /> 501(c)(3) umbrella as a YCP supported initiative of Fluid Revolutions and Abby Hylton.) <br /> Program Primary Contact and Title: Abby Hylton, Program Director <br /> Telephone Number: (919) 428-6233 E-Mail: abby.hylton @gmail.com <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> ❑ Priority Area #1: safety-net services for disadvantaged residents <br /> ® 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 Youth Adult Elderly Disabled Public Housing <br /> Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X <br /> Family Resources <br /> Jobs/Jobs Training <br /> Food <br /> Transportation <br /> Other: Youth <br /> Leadership X <br /> Development, creation <br /> of safe spaces <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)to <br /> be funded. For each, briefly describe the coordinated/collaborative efforts. <br /> • iNSIDEoUT collaborates with QYDI on special events such as dances and socials. <br /> • Street Scene Teen Center provides space for QYDI and Fluid Revolutions' political- <br /> social discussions. <br /> DO NOT SUBMIT THIS PAGE 1/31/2017 12:37:26 PM Page 36 of 45 <br />