Orange County NC Website
Browse       Search
Agency Information2/9/2017 4:13:51 PM Page 11 of 22 <br />h)Agency Budget <br />i.Is your agency currently receiving and/or requesting other(non-Human Services) <br />local (Town of Carrboro, Town of Chapel Hill, Orange County) government <br />funding?(Yes/No)Yes <br />If yes, please list below: <br />Include all programs that have funding requests/awards/totalsfrom Carrboro, Chapel Hill, <br />and Orange County governments(other than Human Services). DO NOT include federal <br />funding sources, such as CDBG and HOME. <br />Program FY16-17 <br />Award <br />FY17-18 <br />Request <br />Source <br />Ex: Affordable Rental <br />Rehabilitation <br />0 $20,000 Carrboro -Affordable Housing <br />Ex: Agency Administration $15,000 $15,000 Carrboro –Other <br />Ex.Total $15,000 $35,000 Carrboro Total Funding <br />Spoke’n Revolution tour of <br />the Trail of Tears <br />$2,000$5,000Town of Chapel Hill funding <br />Spoke’n Revolution tour of <br />the Trail of Tears <br />$1,250$5000Town of Carrboro funding <br />Spoke’nRevolution tour of <br />the Trail of Tears <br />$1,000$5,000Orange County funding <br />*Add rows or attach additional page, if needed. <br />ii.Submit your agency’s budget.You may complete the provided template (separate <br />xlsfile) or you may submit your own budget file (as long as it contains the same <br />information, and in a similar format, asrequested in the provided template). <br />Agency Budgets are required to define budget amounts for the previous program <br />year, current program year, and next program year for the following categories: <br />x Revenues <br />o Private Donations <br />o Program Generated Revenue <br />o Local Government Grants <br />Carrboro Human Services <br />Carrboro Other <br />EXHIBIT A <br />PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: 0D59222E-5A4E-4094-9D22-7F342E2FD1A3