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DocuSign Envelope ID:380F50AD-C98D-426B-80DC-9Al34EB8DA24 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <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 28747 28747 <br /> Female 31578 31578 <br /> Total 0 60325 60325 <br /> Ethnicity <br /> African-American 9328 9328 <br /> American Indian or Alaska Native <br /> Asian 2835 2835 <br /> Caucasian 38279 38279 <br /> Native Hawaiian or other Pacific Islander <br /> Other: specify Multi-Cultural 4634 4634 <br /> Other: specify Hispanic 5249 5249 <br /> Total 0 60325 60325 <br /> Of the above, how many Hispanic/Latino 5249 5249 <br /> Of the above, how many non-Hispanic/Latino 55076 55076 <br /> Total 0 60325 60325 <br /> Age <br /> 0-5 years 3004 3004 <br /> 6-18 years 12076 12076 <br /> 19-50 years 33155 43155 <br /> 51+ years 12090 12090 <br /> Total 0 60325 60325 <br /> Geographic Location <br /> Alamance County <br /> Chatham County <br /> Durham County <br /> Wake County <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 3000 3000 <br /> Town of Chapel Hill (Non-Public Housing) 43434 43434 <br /> Town of Carrboro 13891 13891 <br /> Town of Hillsborough <br /> City of Mebane (Orange County) <br /> Orange County (Outside Municipalities) <br /> Total 0 60325 60325 <br /> PROGRAM INFORMATION 1/31/2017 3:02:18 PM P a g e 14 o f 1 8 <br />