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2022-407-E-Health-OC Rape Crisis Center-Outside Agency
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2022-407-E-Health-OC Rape Crisis Center-Outside Agency
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Last modified
8/30/2022 2:02:30 PM
Creation date
8/31/2022 8:35:34 AM
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Template:
Contract
Date
8/25/2022
Contract Starting Date
8/25/2022
Contract Ending Date
8/30/2022
Contract Document Type
Contract
Amount
$62,000.00
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Program information P a g e 18 of 32 <br />8.Target Population: Please complete the table below with numbers (not percentages) of individuals served <br />and projected to be served. <br />Program Target Population Demographics <br />Projected <br /> 2020- <br />2021 <br />Actual <br />2020- <br />2021 <br />Projected <br /> 2021-2022 <br />Projected <br /> 2022-2023 <br />Gender <br />Men N/A N/A N/A 10 <br />Women 40 <br />Nonbinary/Genderqueer 10 <br />Self-Describe 0 <br />Unknown 0 <br />Total 60 <br />Race and Ethnicity <br />Black or African-American 25 <br />American Indian or Alaska Native 0 <br />Asian Indian 0 <br />White 15 <br />Native Hawaiian or other Pacific Islander 0 <br />Chinese <br />Japanese <br />Vietnamese <br />Filipino <br />Korean <br /> Some other race 10 <br />Unknown 15 <br />0 60 <br />Of the above, how many Hispanic, Latino or Spanish origin 15 <br />Of the above, how many non-Hispanic, Latino or Spanish origin 45 <br />Total 60 <br />Age <br />0-5 years 0 <br />6-18 years 0 <br />19-50 years 50 <br />51+ years 10 <br />Unknown <br />Total 60 <br />Geographic Location <br />Town of Chapel Hill 20 <br />Town of Carrboro 10 <br />Orange County ( Outside of Chapel Hill/Carrboro) 20 <br />Outside of Orange County 10 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: D5354C91-47B9-4630-B4CE-FB86A8E9DAB6
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