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DocuSign Envelope ID: BE69DOF4-65F9-4511-85C7-BCBB1 0605A1 1 <br /> ORANGE COUNTY <br /> Outside Agencies/Human Services <br /> Native Hawaiian or other Pacific Islander 0 4 0 0 <br /> Two or more races 10 14 10 10 <br /> Some other race 0 6 0 0 <br /> Total 150 143 150 150 <br /> Of the above, how many Hispanic/Latino 45 30 45 45 <br /> Of the above, how many non-Hispanic/Latino 105 113 105 105 <br /> Total 150 143 150 150 <br /> Age <br /> 0-5 years 0 0 0 0 <br /> 6-18 years 150 143 150 150 <br /> 19-50 years 0 0 0 0 <br /> 51+years 0 0 0 0 <br /> Total 150 143 150 150 <br /> Geographic Location <br /> Town of Chapel Hill 85 82 85 85 <br /> Town of Carrboro 15 29 15 15 <br /> Orange County(Outside of Chapel Hill/Carrboro) 50 25 50 50 <br /> Outside of Orange County 0 7 0 0 <br /> Total 150 143 150 150 <br /> Income <br /> Low-income(80%of the Area Median Income and Below) na na na na <br /> Total na na na na <br /> 8. Cost Per Individual <br /> This cost per individual must reflect the total program budget divided by the total number of program <br /> individuals in this application. <br /> Actual 2018-19 Projected 2019-20 Projected 2020-21 <br /> Total Cost of Program 232,918 226,380 240,165 <br /> Total # of Individuals * 373 355 355 <br /> Cost Per Individual 624.45 637.69 676.52 <br /> * We define V of individuals"in terms of weighted Units of Service. A Unit Of Service <br /> reflects the services each student receives in terms of 1:1 time with program staff, `dosage' <br /> of services they receive such as social-emotional skill building groups, academic <br /> engagement (tutoring, communicating with teachers) and in-school follow-up support post- <br /> suspension. <br /> Cover Page P a g e 7 _ 8 <br />