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DocuSign Envelope ID: 1BB65AEA-3E6A-45BE-8A7F-19FFOF9A712A <br /> EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Orange County (Outside Municipalities) 1610 1892 <br /> Total 0 610 1892 <br /> Work Statement <br /> o) Complete the Work Statement Chart to describe the work to be performed. <br /> This chart is used to document program activities, program goals, performance measures, <br /> and actual results. (Add more rows as needed) If this is a new program, you will only <br /> document the projected information. Every program is required to have AT LEAST 1 Program <br /> Activity, which should be SMART (Specific, Measurable, Achievable, Relevant, and <br /> Time-bound. Click on SMART Goals to learn more. <br /> • Program Activities should outline major activities the agency implements to accomplish its <br /> program goals. (i.e. Deliver meals to elderly/disabled residents.) <br /> • Program Goal should explain what the program is trying to achieve/accomplish. Goals are <br /> statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br /> Monday-Friday.) <br /> • Performance Measures describe how you will evaluate the degree in which you achieved <br /> the stated goals. (i.e. Will track the number of meals delivered each day.) <br /> • Actual Program Results use program results to indicate the actual measurable <br /> achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of <br /> 105 meals per day.) <br /> Work Statement Chart for Program Kidzu Children's Museum <br /> 1. Program Activity Name STEM Box activities ("museum in a box") <br /> Program Goal Provide 8 hour long STEM activities to youth aged 1-12 in <br /> four sites (Cedar Grove Community Ctr SUMMER ONLY, <br /> New Hope Elementary, Fairview Child and Family Ctr and <br /> Efland Cheeks Community Ctr). Serve upwards of 200 <br /> children between four sites throughout the contract period. <br /> Promote STEM education and design thinking process. <br /> Performance Measures Program attendance, tracking ages, ethnicity and residence; <br /> post program quantitative survey data measuring <br /> understanding and educational value of key STEM learning <br /> concepts. Serve 50 children at Cedar Grove, 50 children at <br /> New Hope Elementary, 25 children at Fairview Child and <br /> Family Ctr and 40 children at Efland Cheeks. <br /> Previous Year Program Results The programming for Cedar Grove will take place June 2018 <br /> and throughout the Spring for New Hope Elementary. <br /> Current Year Estimated Results We estimate serving 100 children through our 2017/18 STEM <br /> Box programming. We estimate over 65% of participants will <br /> experience an increase in understanding STEM learning <br />