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<br />HOPWA SUPPLEMENTAL FORM <br /> <br />EXHIBIT A <br /> <br />DEMOGRAPHICS <br /> <br />Persons Serviced <br />Number of Persons with HIV/AIDS <br />Number of Other Persons in Family Unit <br /> <br />Total Families Assisted with Housing Assistance: <br /> <br />Age & Gender <br /> <br />Under 18 <br /> <br />18.30 <br /> <br />Male: <br />Female: <br />Total: <br /> <br />Receiving Housing Assistance <br /> <br />TOTAL <br /> <br />31.50 <br /> <br />Income Group of Individuals and Family Units per Month <br />$0.$250 $251.$500 $5001.$1000 $1001.$1500 <br /> <br />Race/Ethnicity <br /> <br />White: <br />Black/African American: <br />Asian: <br />American Indian/Alaskan Native: <br />Native Hawaiian/Other Pacific Islander: <br />American Indian/Alaskan Native & White: <br />Asian & White: <br />Black/African American & White: <br />Am. Indian/Alaskan Native & Black/African Am.: <br />Other Multi-Racial: <br />Total: <br /> <br />Recent Living Situation Count: <br />Homeless/Streets: <br />Transitional Housing: <br />Emergency Shelter: <br />Psychiatric Facility: <br />Substance Abuse Treatment: <br />Hospital/Medical: <br />Jail/Prison: <br />Domestic Violence: <br />Living w/ Relative/Friend: <br />Rental Housing: <br />Participant-owned Housing: <br />Other: <br />SUPPLEMENTAL <br /> <br />No. Total <br /> <br />Over 50 <br /> <br />Total <br /> <br />$1501.$2000 <br /> <br />Over $2000 <br /> <br />No. Hispanic <br /> <br />7 of 7 <br />