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13 <br /> OR"E COUNTY <br /> Outside Agencies/Human Services <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 /> ❑ Behavior Health ❑ Public Health& Health Education <br /> ❑ Food&Nutritional Service ❑ Recreational <br /> ❑ Housing ❑ Senior Services <br /> ❑ Human Rights & Community Services ❑ Youth Services <br /> ❑ Juvenile & Adult Justice Services ❑ 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 /> • If you use percentages, please put the actual number equivalence. <br /> • Please ensure your performance measures are outcome based and not outputs. <br /> Program Goal# 1 <br /> Performance Measure <br /> (How will you accomplish your goal?) <br /> Actual Results <br /> (Outcome) <br /> Ending FY2023 <br /> Projected Results <br /> (Outcome) <br /> Ending FY2024 <br /> Projected Results <br /> (Outcome) <br /> Ending FY2025 <br /> Program Goal# 2 <br /> Performance Measure <br /> (How will you accomplish your goal?) <br /> Program informatior P a g e 11 o f 2 1 <br />