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DocuSign Envelope ID:380F50AD-C98D-426B-80DC-9Al34EB8DA24 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: ConnectMe! <br /> Program Primary Contact and Title: Tabitha Blackwell, Protect Executive Director <br /> Telephone Number: (919) 960-1673 E-Mail: tblackwell(@chcyouth.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 <br /> Family Resources X X X <br /> Jobs/Jobs Training <br /> Food <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 <br /> Program(s) to be funded. For each, briefly describe the coordinated/collaborative <br /> efforts. <br /> • The ConnectMe! App will highlight the youth serving organizations in the <br /> community. I will list their programs, services, service learning opportunities, and <br /> events for youth and parents to browse. <br /> • In addition, it will sync with Google Maps to indicate how to get to the location for <br /> the program, service, or event via Chapel Hill Public Transit, bike, walking, or <br /> car. <br /> • The ConnectMe! App was originally designed in partnership with a team of UNC <br /> students through an APPLES Service Learning Course. <br /> PROGRAM INFORMATION 1/31/2017 3:02:18 PM Page 11 of 18 <br />