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DocuSign Envelope ID:4FF28E49-EE56-4A40-9331-F55AA8A05998 <br /> EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME: Newcomers Art Therapy Program <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2016-17 2017-18 2018-19 Change <br /> Private Donations $ 8,000 $ 10,000 $ 10,000 0% <br /> Program Generated Revenue $ 114,000 $ 110,000 $ 130,000 18% <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ 4,000 $ 5,000 $ 10,000 100% <br /> Other-Town of Carrboro $ - $ - $ - 0 <br /> Human Services-Town of Chapel Hill $ 3,000 $ 3,000 $ 15,000 400% <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County $ 1,000 $ - $ - 0 <br /> Other-Orange County $ - $ 3,300 $ 5,000 52% <br /> Other-Town of Hillsborough $ $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way $ $ - $ - 0 <br /> State Government $ $ - $ - 0 <br /> Federal Government(CDBG/HOME/etc.) $ $ - $ - 0 <br /> Private Foundation Grants $ $ 22,000.00 $ 10,000.00 $ 0.55 <br /> Other Revenue $ 3,000 $ - $ - 0 <br /> Total Program Revenue $ 133,000 $ 153,300 $ 180,000 170 <br /> PROGRAM EXPENSES <br /> Compensation $ 112,000 $ 120,000 $ 145,000 21% <br /> Rent&Utilities $ 3,500 $ 4,000 $ 4,500 13% <br /> Supplies&Equipment $ 4,000 $ 5,000 $ 6,000 20% <br /> Travel&Training $ 800 $ 2,500 $ 2,500 0% <br /> Other Expenses: Research and Evaluation Costs $ 3,500 $ 10,000 $ 15,000 50% <br /> Total Program Expenses $ 123,800 $ 141,500 $ 173,000 22% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ 9,200 1 $ 11,800 $ 7,000 1 -41% <br /> FY 2018-19 Program Budget <br />