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DocuSign Envelope ID: D3ADCOFO-56OB-45AA-A3EA-B65E3A3AO6DE XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> • McDougle Middle School: Provide information/support to feed attending kids. <br /> • Culbreth Middle School: Provide information/support to feed attending kids. <br /> • Phillips Middle School: Provide information/support to feed attending kids. <br /> • Smith Middle School: Provide information/support to feed attending kids. <br /> • Mi Escuelita: Provide information/support to feed attending kids. <br /> • Chapel Hill-Carrboro City Schools Pre-K/Head Start Program: Provide <br /> information/support to feed attending kids. <br /> • Dobbins Hill Family Resource Center: Provide information/support to feed attending <br /> kids. <br /> • Town of Chapel Hill (Public Housing Facilities): Provide informationlsupport to feed <br /> attending kids. <br /> • El Centro Hispano: Provide information/support to feed attending kids. <br /> • Hargraves Community Center: Provide information/support to feed attending kids. <br /> • Communiversity: Provide information/support to feed attending kids. <br /> • Rogers-Eubanks Neighborhood Association: Provide information/support to feed <br /> attending kids. <br /> • Street Scene Teen Center: Provide information/support to feed attending kids. <br /> • Maple View Farms: Donate fresh milk every week to kids through WMBP. Also <br /> partnered to create a field trip opportunity for our kids. <br /> • Farmer Foodshare: Partner to provide purchased and donated fresh food to kids via <br /> WMBP. <br /> • Weaver Street Market: Help us raise funds/food for programs. Provide services for <br /> TABLE to purchase food for WMBP and Summer TABLE. <br /> • Food for the Summer: Help us to efficiently reach and serve additional children in the <br /> summer. <br /> Program Description (3 pages OR LESS) Answers d- k are attached <br /> Please provide the following information about the proposed program: <br /> d) Summarize the program services proposed and how the program will address a <br /> Town/County priority/goal? <br /> e) Describe the community need or problem to be addressed in relation to the Chapel Hill <br /> Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of <br /> Chapel Hill Council Goals, Carrboro Board Priorities, or other community priorities (i.e. <br /> Council/Board Goals). Reference local data (using the provided links, i.e. Chapel Hill Human <br /> Services Needs Assessment) to support the need for this program. <br /> f) Who is your target population of individuals to benefit from this program and how will they be <br /> identified and connected with the program? <br /> g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program <br /> Manager and credentials, describe training provided to volunteers, etc.) <br /> PROGRAM INFORMATION 1/30/2017 4:15:08 PM P a g e 1 2 o f 1 9 <br />