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Outside Agencies/Human Services <br />Program information P a g e 2 2 o f 3 2 <br />Please select which function area best aligns with your agency and program(s) in which you are <br />requesting funding. Please select only one from the list below: <br />տ Behavior Health ܆ Public Health & Health Education <br />܈ Food & Nutritional Service տ Recreationalտ Housing տ Senior Servicesտ Human Rights & Community Services տ Youth Services տ Juvenile & Adult Justice Services տ Other <br />If you selected other, please tell us what function area best aligns with your organization: <br />Please indicate three program goals/performance measures below. <br />A few notes: <br />x If you use percentages, please put the actual number equivalence. <br />x Please ensure your performance measures are outcome based and not outputs. <br />Program Goal # 1 <br />Community Market will collect and purchase enough <br />food items to provide groceries as often as once a <br />month to member households. <br />Performance Measure <br />(How will you accomplish your goal?) <br /># of households that receive food assistance <br />Actual Results <br />(Outcome) <br />Ending FY2022 <br />2,336 <br />Projected Results <br />(Outcome) <br />Ending FY2023 <br />3,200 <br />Projected Results <br />(Outcome) <br />Ending FY2024 <br />3,200 <br />Program Goal # 2 <br />A balanced, nutritionally dense meal will be served to <br />any hungry person who shows up at meal times at the <br />Community Kitchen and/or to residents at one of the <br />shelters. <br />DocuSign Envelope ID: B72B9D20-BFE7-4847-8488-DC08B39534B9