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DocuSign Envelope ID:C70973D3-D989-4F31-A95E-3BCC099C95E7 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Additional Program Information <br /> 1) Target Population <br /> Complete the following tables, with numbers (not percentages) of individuals served and to be <br /> served, to the best of your ability <br /> Program Target Population Demographics <br /> Actual Estimated Projected <br /> 2015-16 2016-17 2017-18 <br /> Gender <br /> Male 96 126 125 <br /> Female 67 104 120 <br /> Total 163 230 245 <br /> Ethnicity <br /> African-American 4 5 5 <br /> American Indian or Alaska Native <br /> Asian 99 150 160 <br /> Caucasian <br /> Native Hawaiian or other Pacific Islander <br /> Other: specify:Latino/Latina 60 75 80 <br /> Total 163 230 245 <br /> Of the above, how many Hispanic/Latino 60 75 80 <br /> Of the above, how many non-Hispanic/Latino 103 155 165 <br /> Total 163 230 245 <br /> Age <br /> 0-5 years <br /> 6-18 years 151 200 215 <br /> 19-50 years 12 15 15 <br /> 51+ years 15 15 <br /> Total 163 230 245 <br /> Geographic Location <br /> Alamance County <br /> Chatham County <br /> Durham County 40 50 50 <br /> Wake County <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 30 30 35 <br /> Town of Chapel Hill (Non-Public Housing) 32 80 85 <br /> Town of Carrboro 61 70 75 <br /> Town of Hillsborough <br /> City of Mebane (Orange County) <br /> Orange County(Outside Municipalities) <br /> Total 1 163 230 245 <br /> PROGRAM INFORMATION 2/8/2017 3:01:12 PM Page 15 of 20 <br />