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Actual <br />2019-20 <br /> Estimated <br />2020-21 <br /> Projected <br />2021-22 <br />Percent <br />Change <br />102,843$ 100,000$ 100,000$ 0% <br />-$ 0 <br />2,250$ 5,000$ 5,000$ 0% <br />-$ -$ 0 <br />5,000$ 6,000$ 6,000$ 0% <br />-$ -$ -$ 0 <br />5,000$ 5,000$ 5,000$ 0% <br />-$ -$ -$ 0 <br />-$ -$ -$ 0 <br />80.00$ -$ -$ 0 <br />-$ -$ -$ 0 <br />-$ -$ -$ 0 <br />Private Foundation Grants 14,000.00$ 14,000.00$ 14,000.00$ -$ <br />25,000$ 25,000$ 25,000$ -$ <br />154,173$ 155,000$ 155,000$ 0% <br />85,173$ 82,000$ 82,000$ 0% <br />10,000$ 10,000$ 10,000$ 0% <br />5,000$ 5,000$ 5,000$ 0% <br />4,000$ 5,000$ 5,000$ 0% <br />50,000$ 53,000$ 53,000$ 0% <br />154,173$ 155,000$ 155,000$ 0% <br />-$ -$ -$ 0 <br />Please explain Other Grants <br />Does your program budget show a surplus or deficit? Please provide a brief explanation for the surplus or deficit. <br />Operating Budget for Specific Program <br />Program Budget <br />PROGRAM REVENUE <br />If you are requesting funds for more than one program, a program budget worksheet should be provided for each program. <br />PROGRAM NAME:Pre-Health Internship Program <br />Private Donations <br />Program Generated Revenue <br />Local Government Grants: <br />Human Services - Town of Carrboro <br />Other - Town of Carrboro <br />Human Services - Town of Chapel Hill <br />Other - Town of Chapel Hill <br />Human Services - Orange County <br />Other - Orange County <br />Other - Town of Hillsborough <br />Other Government Grants <br />Triangle United Way <br />State Government <br />Travel & Training <br />Other Expenses: <br />Federal Government (CDBG/HOME/etc.) <br />Supplies & Equipment <br />Other Revenue <br />Total Program Revenue <br />PROGRAM EXPENSES <br />Compensation <br />Rent & Utilities <br />SURPLUS/(DEFICIT) FOR PERIOD: <br />Total Program Expenses <br />FY 2021-22 Program Budget <br />DocuSign Envelope ID: 9B1DC55D-94EA-40F5-BA24-B9B5CF170083