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<br />Program information P a g e 15 o f 28 <br />Town of Carrboro 195 183 203 208 <br />Orange County (Outside of Chapel <br />Hill/Carrboro) 82 83 <br /> <br />87 <br /> <br />87 <br />Outside of Orange County 5 0 0 0 <br />Unknown 0 0 6 6 <br />Total 750 730 775 800 <br />Income <br />Low-income (80% of the Area <br />Median Income and Below). Please <br />see income table in the attachments <br />491 <br />(unknown <br />TBD) <br />489 <br />(232 <br />unknown; <br />9 above 80% <br />poverty line) <br />519 <br />(unknown <br />TBD) <br />536 <br />(unknown <br />TBD) <br />Total 750 730 775 800 <br /> <br /> <br />9. Cost Per Individual <br /> <br />This cost per individual must reflect the total program budget divided by the total <br />number of program individuals in this application. <br /> <br /> Actual 2020- <br />2021 <br />Projected 2021- <br />2022 <br />Projected 2022- <br />2023 <br />Total Cost of Program $605,506 $667,963 $712,000 <br />Total # of Individuals 730 775 800 <br />Cost Per Individual 829 861 890 <br /> <br />10. Performance Indicators <br />For Chapel Hill and Carrboro applicants: <br />Please complete the following chart with information about the Strategic Objective, <br />Intermediate Result, and the Agency Performance Indicator for each program for which you <br />are applying for funding. Please see the Results Framework in the Attachments section as a <br />reference. <br /> <br />Program Name: TABLE@Home <br /> <br />Strategic <br />Objective <br />(please choose <br />one from the <br />Results <br />Framework) <br /> Children improve their educational outcomes <br /> X Residents increase their livelihood security <br /> <br /> X Residents improve their health outcomes <br /> <br /> <br />Intermediate <br />Result <br />(please choose <br />one from the <br />Insert Intermediate Result here. <br /> <br />2.1 Residents access the most appropriate social safety net services <br />3.2 Residents demonstrate new healthy lifestyle behaviors <br /> <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: 5334673A-3749-4438-A4C5-1C05EECD11F3