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Program information P a g e 12 of 32 <br />Total 695 529 695 700 <br />Age <br />0-5 years 0 0 0 0 <br />6-18 years 15 6 15 15 <br />19-50 years 250 87 370 375 <br />51+ years 50 11 60 60 <br />Unknown 380 425 250 250 <br />Total 695 529 695 700 <br />Geographic Location <br />Town of Chapel Hill 150 68 175 175 <br />Town of Carrboro 45 2 40 45 <br />Orange County ( Outside of Chapel Hill/Carrboro) 150 57 185 185 <br />Outside of Orange County 75 5 45 45 <br />Unknown 275 397 250 250 <br />Total 695 529 695 700 <br />Income <br />Low-income (80% of the Area Median Income and Below) Please see income <br />table in the attachments n/a n/a <br />n/a n/a <br />Total 0 0 0 0 <br />9.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 2020-2021 Projected 2021-2022 Projected 2022-2023 <br />Total Cost of Program 738,229 679,101 675000 <br />Total # of Individuals 529 695 700 <br />Cost Per Individual 1395 977 964 <br />10.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: Rape Crisis Victim’s Services <br />Strategic <br />Objective <br />(please choose one from <br />the Results Framework) <br />† Children improve their educational outcomes <br />X Residents Increase their livelihood security <br />† Residents improve their health outcomes <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: D5354C91-47B9-4630-B4CE-FB86A8E9DAB6