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<br />Program information Page 21 of 33 <br />Outside of Orange County N/A 2 1 1 <br />Total N/A 34 50 50 <br />Income <br /> <br />Low-income (80% of the Area Median Income and Below) Please see <br />income table in the attachments N/A 100% <br />100% 100% <br />Total N/A 34 50 50 <br /> <br /> <br /> <br />9. Cost Per Individual: Youth and Children’s Program <br /> <br />This cost per individual must reflect the total program budget divided by the total number of <br />program individuals in this application. <br /> <br />*Note: Program did not request funding in 2020-2021 or 2021-2022 due to COVID undertainty <br /> <br /> Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 <br />Total Cost of Program N/A N/A $62,755 <br />Total # of Individuals N/A N/A 50 <br />Cost Per Individual N/A N/A $1,255 <br /> <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 /> <br />Program Name: Youth and Children’s Program <br /> <br />Strategic <br />Objective <br />(please choose one from <br />the Results Framework) <br />Ö Children improve their educational outcomes <br /> <br />Intermediate <br />Result <br />(please choose one from <br />the Results Framework) <br />Children demonstrate new grade-level-appropriate skills. <br /> <br />RESULTS Actual <br /> 2020-2021 <br />Projected <br /> 2021-2022 <br />Projected <br /> 2022-2023 <br />Performance Indicators <br />(Please choose at least one performance indicator to report on from the Results Framework, and add additional performance <br />indicators that you would like to report to the Towns. Please insert additional rows as needed, listing one per row). <br />% and # of program participants <br />that improve grades by end of <br />program period <br />Program not <br />offered due to <br />COVID in 2020- <br />2021 <br />Teen Program and <br />Youth Children’s <br />Program restarted <br />May of 2021 <br />75% of 50 program <br />participants <br />improve grades <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: F38AEFE6-1D08-4C4C-8C40-AA9F3F782631