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Cover Page P a g e 6 o f 31 <br /> <br />COVER PAGE <br /> <br />Applicant Contact Information <br /> <br />Applicant Organization’s Legal Name: Orange County Rape Crisis Center <br /> <br />Applicant Organization’s Physical Address: 1506 E. Franklin Street, Suite #200 Chapel Hill, NC 27514 <br /> <br />Applicant Organization’s Mailing Address: PO Box 4722, Chapel Hill, NC 27515 <br /> <br />Applicant Organization’s Web Address: www.ocrcc.org <br /> <br />Executive Director: Rachel Valentine <br /> <br />Telephone Number: 9199684647 E-Mail: rvalentine@ocrcc.org <br /> <br />Tax ID Number: 58-1356356 <br /> <br />Funding Request <br /> <br />Please list all Fiscal Year 2022 Human Services (HS) funding requested for all programs and the proposed <br />use of funds (please list program name only) <br />Program Carrboro - <br />HS <br />Chapel <br />Hill - HS <br />Orange <br />County-HS <br />Total <br />Ex. Youth Afterschool Program <br />Operations or Personnel <br />$10,000 <br />Operations <br />$15,000 <br />Personnel <br />$5,000 <br />Operations <br />$30,000 <br />Rape Crisis Victim’s Services <br />Personnel and Operations <br />$10,000 <br /> <br />$20,500 <br /> <br />$26,000 $56,500 <br />Community Engagement for Safe Kids <br />Personnel and Supplies <br />$7,000 <br /> <br />$11,000 $22,000 $40000 <br />Pro Bono Counseling Network <br />Personnel <br />3000 8,000 14000 $25,000 <br />Totals $20,000 $39,500 $62,000 121,500 <br /> <br />Briefly explain your proposed use of funds: <br /> <br />To the best of my knowledge and belief all information and data in this application is true and <br />current. The document has been duly authorized by the governing board of the applicant. <br />We propose to use these funds in support of comprehensive mental and behavioral health supports <br />for survivors of sexual violence throughout Orange County. Services include maintenance of three <br />bilingual 24-hour crisis lines, 24-hour crisis intervention and medical accompaniment, case <br />management and court advocacy as well as training to provide culturally competent services to <br />underserved communities; outreach, training, and education activities engaging tens of thousands <br />of residents to create a safer community free of child sexual abuse, sexual assault and human <br />trafficking. Finally, this year the OCRCC intends to use these finds to launch the Pro Bono Counseling <br />Network to connect low income residents with free and sliding scale therapy services. <br />DocuSign Envelope ID: A1C5195D-6140-4BAA-8624-408DB5CDAEAA <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: BEA4B8BB-13B7-4322-9698-A424692E9FD4