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DocuSign Envelope ID:380F50AD-C98D-426B-80DC-9Al34EB8DA24 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 2. AGENCY INFORMATION (Be Very Brief and Concise) <br /> Please provide the following information about your agency (2 pages OR LESS): <br /> a) Years in Operation, Date of Incorporation (Month/Year): Tides became Youth Forward's <br /> fiscal agent on January 2014 <br /> b) Agency's Purpose/Mission (no more than a few sentences): <br /> Tides accelerates the pace of social change, working with innovative partners to <br /> solve society's toughest problems. Youth Forward, a project of Tides Center, is <br /> dedicated to advance a seamless array of services aligned to the needs of all youth <br /> in Chapel Hill/Carrboro by working with nonprofits, schools, local governments and <br /> others. <br /> c) Types of Services the Agency Provides (bullet format): <br /> Youth Forward provides three key activities: <br /> • Connecting: Creating tools (website and app) to increase awareness of <br /> nonprofits serving youth. <br /> • Capacity Building: Engaging the nonprofit and philanthropic communities in <br /> order to provide support to agencies. <br /> • Investing: Developing and implementing grant funds for nonprofits that are <br /> addressing the service gap for Chapel Hill and Carrboro youth. <br /> d) Agency's History with Providing These Services: <br /> Youth Forward provides a website, which has a resource directory currently listing <br /> over 100 area youth-serving organizations. Whether it's through the ConnectMe! <br /> App, the Youth Forward website, or community events, such as the annual Youth <br /> Providers Summit that brings together over 60 nonprofit leaders to discuss how to <br /> improve services for youth in the community, Youth Forward provides tools that <br /> connect not only youth to nonprofits, but nonprofits to one another. <br /> e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes <br /> in the past year? Is there a new Executive Director?Are there new initiatives?) <br /> In December 2016, Youth Forward hired its first part time staff member, a <br /> Communication Manager, to help update the website and launch the app in 2017. <br /> f) Schedule of Positions (For Entire Agency) <br /> • Full Time Equivalent(FTE) staff will be noted as 1.00; half time as .50; quarter time as .25, etc. <br /> • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: <br /> Total Volunteer Hours =Volunteer FTE <br /> 2,080 <br /> # of FTE - Full-Time Paid Positions: 1 <br /> # of FTE - Paid Part-Time Positions: 1 <br /> # of Volunteers: 0 # of FTE -Volunteers:0 <br /> g) Living Wage <br /> Does this agency pay permanent employees a minimum living wage? (Yes/No) Yes <br /> If yes, is this agency an Orange County Living Wage Certified Employer? No <br /> If no, please explain. Because we have a fiscal agent in California, we were unaware of this <br /> certification. <br /> Agency Information 1/31/2017 3:02:18 PM Page 8 of 18 <br />