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1/11/24, 11:14 AM HSOA-24-13 <br />https://chapelhillnc.workflow.opengov.com/#/explore/records/62510/react-form-details/62510 1/15 <br />Town of Chapel Hill, NC 1/11/2024 <br />HSOA-24-13 <br />Human Services/Outside Agencies <br />Funding Application Fiscal Year 2025 <br />Status: Active <br />Submitted On: 1/11/2024 <br />Applicant <br />Laura Dille <br />919-636-4860 <br />ldille@tablenc.org <br />311 E. Main St. <br />Carrboro, NC 27510 <br />Agency Information <br />Agency's Legal Name <br />Table Ministries, Inc. <br />Agency's Mailing Address (Street, City, State & Zip <br />Code) <br />311 E. Main St. Carrboro, NC 27510 <br />Agency's Physical Address (Street, City, State & Zip <br />Code) <br />Agency’s Web Address <br />https://www.tablenc.org/ <br />Tax ID: <br />**-***1735 <br />Date of Incorporation (Month/Year) <br />11/2007 <br />Executive Director Name <br />Ashton Tippins <br />E-Mail Address <br />info@tablenc.org <br />Telephone Number <br />9196364860 <br />Exhibit ADocusign Envelope ID: D43192F0-F492-433D-8CDD-C94458BC2F9A