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DocuSign Envelope ID:3457204A-7765-4E36-8B42-227F6F673AF6 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME LGBTQ Youth Community Building Initiatives <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2015-16 2016-17 2017-18 Change <br /> Private Donations $ - $ - $ - 0 <br /> Program Generated Revenue $ - $ - $ - 0 <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ - $ - $ 750 0 <br /> Other-Town of Carrboro $ - $ - $ - 0 <br /> Human Services-Town of Chapel Hill $ - $ 264 $ 2,250 752% <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County $ - $ - $ - 0 <br /> Other-Orange County 1 $ - 1 $ 2,529 1 $ 4,500 78% <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way $ - $ - $ - 0 <br /> State Government $ - $ - $ - 0 <br /> Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 <br /> Private Foundation Grants $ - $ - $ - 0 <br /> Other Revenue $ - $ - $ - 0 <br /> Total Program Revenue $ - $ 2,793 $ 7,500 169% <br /> PROGRAM EXPENSES <br /> Compensation $ - $ 1,443 $ 5,500 281 <br /> Rent& Utilities $ - $ - $ - 0 <br /> Supplies& Equipment $ - $ - $ - 0 <br /> Travel &Training $ - $ 1,350 $ 2,000 48% <br /> Other Expenses: $ - $ - $ - 0 <br /> Total Program Expenses $ - $ 2,793 $ 7,500 169% <br /> SURPLUS/(DEFICIT) FOR PERIOD: I $ - - Is - 1 0 <br />