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DocuSign Envelope ID: FF2F034D-8ED9-46D3-BB8F-E4DD48CFCF88 <br /> ()IRANGE COUNTY <br /> NX '. �� <br /> Outside Agencies/Human Services <br /> Please use the drop down menu below to select which function area best aligns with your agency <br /> and program(s) in which you are requesting funding. Please select only one from the drop down <br /> menu below. <br /> Public Health and Health Education <br /> If you selected other, please tell us what function area best aligns with your organization: <br /> Please indicate three program goals/performance measures below. <br /> A few notes: <br /> • If you use percentages, please put the actual number equivalence. <br /> • Please ensure your performance measures are outcome based and not outputs. <br /> Information'and Referral Service <br /> connects community members with local resources <br /> Parogra�m Goal# and services after assessment of need Resource <br /> d tabase maintained for.a multitude of services: <br /> Follow-up conducted to ensure connection was made <br /> and adc(itional resources rovided asi11 eded. <br /> At the end of the contact, clients are asked whether <br /> Performance Measure they received the inf ormation or help they needed <br /> (HOW will you accon plrslr your <br /> These results are tracked: <br /> Of 1,520 clients, 950X reported knowledge of <br /> Actual Results appropriate social services in FY 18.19. <br /> {outcome) <br /> Erlgbt k FY18-19 . <br /> Pr©3ec#ed Results Of at least 1,29© clients, 85% will report knowledge of <br /> (Outcome} appropriate social services in F1( 19-20 <br /> ndilt FY2026 <br /> Projected Resulits Of'.at least 1,20o clients, 85% v+ill report knowledge of <br /> {,t)lutcme) appropriate social services in FY 20-21. <br /> �tdM FY2021 <br /> Youth Inter ersonal llrolence Prevenfrott Edpcatror <br /> p <br /> Provides age appropriate a#in violence prevention <br /> Prorarm mat# <br /> education sessions in 6 and 8 , grade health <br /> edrea#ion classes <br /> errforrnaz>Ece measure <br /> Participants will be given pre and post sesron <br /> (How w,rllsgrr acconiplrsh yotrrgoal?); <br /> evaluation and resu{ts w�l,fbe tracked: <br /> I'ioriam ir;ic,;w,tic!} <br />