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<br />Program information Page 11 of 22 <br />Native Hawaiian or other Pacific Islander <br />Two or more races <br /> Some other race <br />Total 5243 5243 3936 3936 <br /> <br /> <br />Of the above, how many Hispanic/Latino <br />Of the above, how many non-Hispanic/Latino <br />Total 5243 5243 3936 3936 <br />Age <br />0-5 years <br />6-18 years <br />19-50 years <br />51+ years <br />Total 5243 5243 3936 3936 <br />Geographic Location <br />Town of Chapel Hill <br />Town of Carrboro <br />Orange County ( Outside of Chapel Hill/Carrboro) <br />Outside of Orange County <br />Total 5243 5243 3936 3936 <br />Income <br />Low-income (80% of the Area Median Income and Below) Please see <br />income table in the attachments 5243 5243 <br />3936 <br />3936 <br />Total 5243 5243 3936 3936 <br /> <br /> <br />8. Cost Per Individual <br /> <br />This cost per individual must reflect the total program budget divided by the total number <br />of program individuals in this application. <br /> <br />Note: The number of participants dropped after 2018-19 because TABLE, PORCH and <br />CASA discontinued using produce donated through the Donation Stations. They instead <br />purchase food through our Wholesale Market. This means that more donated food went <br />to the remaining recipient agencies. <br /> <br /> Actual 2018-19 Projected 2019-20 Projected 2020-21 <br />Total Cost of Program $26,649 $24,727 $29,200 <br />Total # of Individuals 5243 3936 3936 <br />Cost Per Individual $5.08 $6.28 $7.42 <br /> <br />9. Performance Indicators <br />For Chapel Hill and Carrboro applicants: <br />Please complete the following chart with information about the Strategic Objective, Intermediate <br />Result, and the Agency Performance Indicator for each program for which you are applying for funding. <br />Please see the Results Framework in the Attachments section as a reference. <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC