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2022-459-E-Health-Transplanting Traditions-Outside agency agreement
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2022-459-E-Health-Transplanting Traditions-Outside agency agreement
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Last modified
9/12/2022 3:54:33 PM
Creation date
9/12/2022 3:54:14 PM
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Contract
Date
9/8/2022
Contract Starting Date
9/8/2022
Contract Ending Date
9/12/2022
Contract Document Type
Contract
Amount
$5,000.00
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<br />Program information Page 20 of 33 <br />Youth and Children’s Program <br />8. Target Population: Please complete the table below with numbers (not percentages) of <br />individuals served and projected to be served. <br />*Note: TTCF has run a Young Children’s Program for youth from Burma since 2012. The program <br />was paused in 2020 due to COVID. In 2021 the program was re-started; however, we didn’t seek <br />Human Services funding in the 2020-2021 application due to the uncertainty of the pandemic. <br />Numbers in the Actual 2020-2021 column represent youth served in 2021. <br /> <br />Program Target Population Demographics <br /> <br />Projected <br /> 2020-2021 <br />Actual <br />2020- <br />2021 <br /> Projected <br /> 2021-2022 <br />Projected <br /> 2022-2023 <br />Gender <br />Men N/A 17 25 25 <br />Women N/A 17 25 25 <br />Nonbinary/Genderqueer N/A 0 0 0 <br />Self-Describe N/A 0 0 0 <br />Total N/A 34 50 50 <br />Race and Ethnicity <br /> <br /> <br />Black or African-American N/A 0 0 0 <br />American Indian or Alaska Native N/A 0 0 0 <br />Asian Indian N/A 0 0 0 <br />White N/A 0 0 0 <br />Native Hawaiian or other Pacific Islander N/A 0 0 0 <br />Chinese <br />Japanese <br />Vietnamese <br />Filipino <br />Korean <br /> From Burma (aka Myamar) N/A 34 25 25 <br />Total N/A 34 50 50 <br /> <br />Of the above, how many Hispanic, Latino or Spanish origin N/A 0 0 0 <br />Of the above, how many non-Hispanic, Latino or Spanish origin N/A 34 50 50 <br />Total N/A 34 50 50 <br />Age <br />0-5 years N/A 7 10 10 <br />6-18 years N/A 27 40 40 <br />19-50 years N/A 0 0 0 <br />51+ years N/A 0 0 0 <br />Total N/A 34 50 50 <br />Geographic Location <br />Town of Chapel Hill N/A 29 44 44 <br />Town of Carrboro N/A 3 5 5 <br />Orange County ( Outside of Chapel Hill/Carrboro) N/A 0 0 0 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: F38AEFE6-1D08-4C4C-8C40-AA9F3F782631
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