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https://chapelhillnc.workflow.opengov.com/#/explore/records/62492/react-form-details/62492 1/14 <br />Town of Chapel Hill, NC 1/31/2024 <br />HSOA-24-9 <br />Human Services/Outside Agencies <br />Funding Application Fiscal Year 2025 <br />Status: Active <br />Submitted On: 1/10/2024 <br />Applicant <br />Elizabeth Irwin <br />205-994-5015 <br />elizabeth.irwin@ppsat.org <br />1765 Dobbins Drive <br />Chapel Hill, NC 27514 <br />Agency Information <br />Agency's Legal Name <br />Planned Parenthood South Atlantic <br />Agency's Mailing Address (Street, City, State & Zip <br />Code) <br />100 South Boylan Avenue,Raleigh,NC <br />27603 <br />Agency's Physical Address (Street, City, State & Zip <br />Code) <br />100 South Boylan Avenue, Raleigh,NC <br />27603 <br />Agency’s Web Address <br />www.ppsat.org <br />Tax ID: <br />**-***2557 <br />Date of Incorporation (Month/Year) <br />July 1980 <br />Executive Director Name <br />Jenny Black <br />E-Mail Address <br />jenny.black@ppsat.org <br />Telephone Number <br />(919) 833-7534 ext. 6140 <br />Exhibit A <br />Docusign Envelope ID: 9B12EC66-D23F-408C-BE60-EBCDE242CC54