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DocuSign Envelope ID:C70973D3-D989-4F31-A95E-3BCC099C95E7 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME The Art Therapy Institute <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2015-16 2016-17 2017-18 Change <br /> Private Donations $ 7,000 $ 8,000 $ 8,000 0% <br /> Program Generated Revenue $ 85,000 $ 114,000 $ 124,000 9% <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ 3,500 $ 4,000 $ 5,000 25% <br /> Other-Town of Carrboro $ - $ - $ - 0 <br /> Human Services-Town of Chapel Hill $ 2,000 $ 3,000 $ 5,000 67% <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County $ 1,000 $ 1,000 $ 5,000 400% <br /> Other-Orange County $ - $ - $ - 0 <br /> Other-Town of Hillsborough $ - 1 $ - 1 $ - 0 <br /> Other Government Grants ME <br /> Triangle United Way $ - $ - $ - 0 <br /> State Government $ - $ - $ - 0 <br /> Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 <br /> Private Foundation Grants $ - $ - $ - 0 <br /> Other Revenue $ 3,000 $ 3,000 $ 1,000 $ (0.67) <br /> Total Program Revenue rs 101,500 $ 133,000 $ 148,000 11% <br /> PROGRAM EXPENSES <br /> Compensation $ 85,000 $ 112,000 $ 122,000 9% <br /> Rent&Utilities $ 2,600 $ 3,500 $ 4,000 14% <br /> Supplies & Equipment $ 3,600 $ 4,000 $ 4,500 13% <br /> Travel &Training $ 700 $ 800 $ 1,500 88% <br /> Other Expenses: $ 2,500 $ 3,500 $ 4,000 14% <br /> Total Program Expenses $ 94,400 $ 123,800 1 $ 136,000 1 10% <br /> SURPLUS/(DEFICIT) FOR PERIOD: 1 $ 7,100 $ 9,200 1 $ 12,000 1 307/6 <br />