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Outside Agencies/Human Services <br />Please use the drop down menu below to select which function area best aligns with your <br />agency and program(s) in which you are requesting funding.Please select only one from <br />the drop-down menu below. <br />Public health and health education <br />If you selected other, please tell us what function area best aligns with your organization: <br />Please indicate three program goals/performance measures below. <br />A few notes: <br />● If you use percentages, please put the actual number equivalence. <br />● Please ensure your performance measures are outcome based and not outputs. <br />Program Goal # 1 Adolescents will engage with the program and <br />learn new life skills <br />Performance Measure <br />(How will you accomplish <br />your goal?) <br />Number of adolescents who participate in <br />multi-session, evidence-based curricula; average <br />increase in knowledge about pregnancy and STI <br />prevention. <br />Actual Results <br />(Outcome) <br />Ending FY2021 <br />22; 4% <br />Projected Results <br />(Outcome) <br />Ending FY2022 <br />30; 25% <br />Projected Results <br />(Outcome) <br />Ending FY2023 <br />25; 25% <br />Program Goal # 2 Parents will have the skills and information they <br />need to talk to their children about sexuality <br />Performance Measure <br />(How will you accomplish <br />your goal?) <br />Number of parents reached through parent <br />workshops; percentage of parents who report an <br />increased comfort in talking about sexuality with <br />their children <br />Program informationPage 9 of 10 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATIONDocuSign Envelope ID: 70AC09D8-3205-4A8F-BDE0-893B802CD27D