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Cover Page Page 6 of 32 <br />COVER PAGE <br />Applicant Contact Information <br />Applicant Organization’s Legal Name: Orange County Rape Crisis Center <br />Applicant Organization’s Physical Address: 1229 E Franklin Street Chapel Hill, NC 20514 <br />Applicant Organization’s Mailing Address: PO Boc 4722, Chapel Hill, NC 27514 <br />Applicant Organization’s Web Address: ocrcc.org <br />Executive Director: Rachel Valentine <br />Telephone Number: 919-968-4647 E-Mail: rvalentine@ocrcc.org <br />Tax ID Number: <br />Funding Request <br />Please list all Fiscal Year 2023 Human Services (HS) funding requested for all programs and the proposed <br />use of funds (please list program name only) <br />Program Carrboro - <br />HS <br />Chapel <br />Hill - HS <br />Orange <br />County-HS <br />Total <br />Ex. Youth Afterschool Program <br />Operations or Personnel <br />$10,000 <br />Operations <br />$15,000 <br />Personnel <br />$5,000 <br />Operations <br />$30,000 <br />Rape Crisis Victim’s Services 10,000 20,500 26,000 56,500 <br />Community Engagement for Safe Kids 7,000 13,000 22,000 42,000 <br />Therapy Access for Underserved Communities 1,000 10,000 14,000 25,000 <br />Totals 18,000 43,500 62,000 123,000 <br />Briefly explain your proposed use of funds: <br />To the best of my knowledge and belief all information and data in this application is true and <br />current. The document has been duly authorized by the governing board of the applicant. <br />We propose to use these funds in support of comprehensive mental and behavioral health supports <br />for survivors of sexual violence throughout Orange County. Services include maintenance of three <br />bilingual 24-hour crisis lines, 24-hour crisis intervention and medical accompaniment, case <br />management and court advocacy as well as training to provide culturally competent services to <br />underserved communities; outreach, training, and education activities engaging tens of thousands <br />of residents to create a safer community free of child sexual abuse, sexual assault and human <br />trafficking. Finally, this year the OCRCC seeks to fund the Therapy Access for Underserved <br />Communities program to connect BIPOC and transgender low income residents with free and sliding <br />scale therapy services. <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: D5354C91-47B9-4630-B4CE-FB86A8E9DAB6