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Program information P a g e 10 o f 20 <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 2019-20 Projected 2020-21 Projected 2021-22 <br />Total Cost of Program <br />Total # of Individuals <br />Cost Per Individual <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: <br />Strategic <br />Objective <br />(please choose one from <br />the Results Framework) <br />Children improve their educational outcomes <br />Residents Increase their livelihood security <br />Residents improve their health outcomes <br />Intermediate <br />Result <br />(please choose one from <br />the Results Framework) <br />Insert Intermediate Result here. <br />Actual <br />2019-20 <br />Projected <br />2020-21 <br />Projected <br /> 2021-22 <br />Performance <br />Indicators <br />(Please choose at least <br />one performance <br />indicator to report on <br />from the Results <br />Framework, and add <br />additional performance <br />indicators that you <br />would like to report to <br />the Towns. Please <br />insert additional rows as <br />needed, listing one per <br />row). <br />533 380 380 <br />$49,093 <br />x <br />3.2 Residents demonstrate new healthy lifestyle behaviors. <br />% and # of program participants who demonstrate new life skills: <br />Number of adolescents who participate in multi-session, evidence-based curricula. <br />Average increase in knowledge about pregnancy and STI prevention. <br />32 <br />27% <br />30 <br />25% <br />30 <br />25% <br />Number of students reached by peer educators <br />Number of parents reached through parent <br />workshops <br />Percentage of parents who report an increased <br />comfort in talking about sexuality with their <br />children <br />Number of participants reached by single- <br />session programs <br />Percentage of individuals who report an <br />increased understanding of their risk of <br />pregnancy or STI transmission <br />480 300 300 <br />6 15 15 <br />100%75%75% <br />14 35 35 <br />93%75%75% <br />$44,917 $50,314 <br />$84.27 $129.19 $132.41 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: 3B9D32F2-BCE5-494E-B2DF-78A17389E8BADocuSign Envelope ID: 01146459-28D7-41C1-ADA0-09401D3877AD