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DocuSign Envelope ID:4FF28E49-EE56-4A40-9331-F55AA8A05998 <br /> EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Additional Program Information <br /> d) 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 /> 2016-17 2017-18 2018-19 <br /> Gender <br /> Male 126 125 130 <br /> Female 104 120 145 <br /> Total 230 245 275 <br /> Ethnicity <br /> African-American 5 5 <br /> American Indian or Alaska Native <br /> Asian 150 160 135 <br /> Caucasian <br /> Native Hawaiian or other Pacific Islander <br /> Other: specify: Refugees and immigrants <br /> from all other countries around the world (non- 75 80 <br /> Asian countries) 140 <br /> Total 230 245 275 <br /> Of the above, how many Hispanic/Latino 75 80 100 <br /> Of the above, how many non-Hispanic/Latino 155 165 175 <br /> Total 230 245 275 <br /> Age <br /> 0-5 years <br /> 6-18 years 200 215 225 <br /> 19-50 years 15 15 30 <br /> 51+ years 15 15 20 <br /> Total 230 245 275 <br /> Geographic Location <br /> Alamance County <br /> Chatham County <br /> Durham County 50 50 75 <br /> Wake County <br /> Orange County Breakdown <br /> Chapel Hill Public Housing 30 35 50 <br /> Town of Chapel Hill (Non-Public Housing) 80 85 110 <br /> Town of Carrboro 70 75 100 <br /> Town of Hillsborough <br /> City of Mebane (Orange County) 5 <br /> Orange County (Outside Municipalities) 10 <br /> Total 230 245 275 <br /> PROGRAM INFORMATION 1/23/2018 10:01:04 AM P a g e 18 of 24 <br />