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DocuSign Envelope ID: D90F57Fl-8076-4358-9941-F62552053F84 <br /> 6-18 years 2 5 2 5 <br /> 19-50 years <br /> 51+years <br /> Total 95 88 110 120 <br /> Geographic Location <br /> Town of Chapel Hill 25 27 30 35 <br /> Town of Carrboro 21 15 26 26 <br /> Orange County(Outside of Chapel Hill/Carrboro) 45 39 50 55 <br /> Outside of Orange County 4 7 4 4 <br /> Total 95 88 110 120 <br /> Income <br /> *Low-income(80%of the Area Median Income and Below) Please 89 95 <br /> see income table in the attachments 75 69 <br /> Total 1 95 88 110 120 <br /> *Low income determined by#of children who are Medicaid eligible <br /> 8. Cost Per Individual <br /> This cost per individual must reflect the total program budget divided by the total number of <br /> program individuals in this application. <br /> Actual 2018-19 Projected 2019-20 Projected 2020-21 <br /> Total Cost of Program 146,638 178,729 186,436 <br /> *Total #of Individuals 202 260 285 <br /> Cost Per Individual $726 $687 $654 <br /> *Includes children and family members served <br /> 9. Performance Indicators <br /> For Chapel Hill and Carrboro applicants: <br /> Please complete the following chart with information about the Strategic Objective, Intermediate Result, and <br /> the Agency Performance Indicator for each program for which you are applying for funding. Please see the <br /> Results Framework in the Attachments section as a reference. <br /> Program Name: KidSCope Outreach <br /> Strategic X Children improve their educational outcomes <br /> Objective ❑ Residents Increase their livelihood security <br /> (please choose one from <br /> the Results Framework) ❑ Residents improve their health outcomes <br /> Intermediate Insert Intermediate Result here. <br /> Result <br /> (please chooseonefrom 1.1 Children birth-to-K access early childhood development opportunities. <br /> the Results Framework) <br /> Fro rain information Page 11 of 28 <br />