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DocuSign Envelope ID:7B55B196-3912-4C1A-ADB4-A753058DFEFD XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: The Arc of the Triangle Social Volunteer and Individual Services <br /> Program Primary Contact and Title: Susan Chandler <br /> Telephone Number: 919 942 5119 E-Mail schandlerp_arctriangle.org <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 X <br /> Jobs/Jobs Training X <br /> Food X <br /> Transportation <br /> Other: Please specify <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) <br /> to be funded. For each, briefly describe the coordinated/collaborative efforts. <br /> • The North Carolina Division of Vocational Rehabilitation (VR) - persons <br /> recommended to The Arc from VR find gainful work with Arc Supported Employment <br /> Specialists. <br /> • Cardinal Innovations Health Care Solutions- families and individuals are <br /> recommended to The Arc to receive Home and Community Support, Respite Care, <br /> Supported Employment, Social and Volunteer opportunities. <br /> • Meals on Wheels (MOW)— Arc participants volunteer weekly delivering and <br /> preparing meals for Chapel Hill and Carrboro Meals on Wheels recipients. Once a <br /> month the Arc's cooking class bakes and donates thirty-six desserts to local MOW <br /> recipients. <br /> • Whole Foods — donates buckets and buckets of beautiful fresh flowers every <br /> Wednesday for the Petals with a Purpose program. <br /> • Extraordinary Ventures (EV) -- Arc participants are hired and employed at EV <br /> for a variety of jobs including Office Solutions, EV Laundry, EV Candle making, EV <br /> Pet sitting, as well as partnering in Friday Night Live a weekly evening at EV for <br /> PROGRAM INFORMATION 1/26/2017 5:52:39 PM P a g e 1 3 o f 2 6 <br />