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-DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 <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 /> Food and Nutritional Services <br /> If you selected other, please tell us what function area best aligns with your organization: <br /> n/a <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 /> w " Food Pantry will collect and purchase enough food <br /> Program Goal#1 3 items to provide groceries as often as once a month to <br /> member households <br /> # of households that receive food assistance ` „ <br /> Performance Measure r <br /> (How will you accomplish your goal?) htp4a '. <br /> Actual Results } � k <br /> (Outcome) <br /> Ending FY18-19 " <br /> r :. . � l" mw� gag <br /> } a <br /> Projected Results 3,200 �1� , <br /> (Outcome) <br /> Ending FY2020 <br /> Projected Results <br /> O <br /> (Outcome) <br /> Ending FY202 • RV <br /> A balanced, nutritionally dense meal will be served to <br /> Program Goal#2 any hungry person who shows up at meal times at the <br /> . � NON- <br /> Community Kitchen and/or to residents at one of the <br /> shelters <br /> # meal provided/food assistance <br /> Performance Measure <br /> (How will you accomplish your goal?) T <br /> Program information P a g e 1 5 o f 2 5 <br />