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Artist Project Grant - Fall <br /> G <br /> 2012-13 Application Form <br /> ORANGE COUNTY ARTS Orange County Arts Commission <br /> COMMISSION <br /> Promoting the artistic and cultural development of Orange County, North Carolina <br /> 1 Artist Information <br /> Applicant Name MARY GAIL' 1Z Tim$ <br /> Mailing Address 13 k K It L oey v;- '. V-hl-L 1JC <br /> Daytime Phone 1115-. 3 S9 • 3 S Fax Number <br /> bb ceM <br /> Email Address J ats-)e- ~v)f s4et, f "Web Site Adot 4e&,- -E-at t GO nil <br /> DUNS Number ® <br /> 2 Grant Request Summary <br /> Arts Program Grant Request 1 I a(> o Total Cash Match volt <br /> Summary Statement for Proposed Use of Arts Program Grant SuPPoR-T PfLe Dy GT10 N A oGUMENTft'►�/V <br /> o f t-%-* "B v 5 w f-Pt P" /Q(l-rry 0 a-tc- N►d IS I L-.>l: AA d A-Ar L <br /> 4 Narrative <br /> Write a description,up to three pages,single spaced,that describes the following under separate subheadings: <br /> • Proposed Project-what will you do,where will it be performed or displayed,when will the preparations <br /> and public component take place,list any organizational partners. <br /> • Community Impact-describe the project's public component,how many people will be impacted. <br /> • Artist Experience -include a brief description of your similar arts projects in the past. <br /> 5 Application Checklist (in this order,do not staple, bind, or put into individual folders) <br /> 1 copy each: (Only 1 sided,8 1/2"x 11, white paper) <br /> • Application Form, Page One, Including Signature <br /> • Narrative <br /> • Budget Sheet <br /> • Itemized Budget(if necessary) <br /> • Resumes of artist(s). <br /> 1 copy each: <br /> • Sample programs, press,or other materials from this or similar past programs. <br /> • Sample work by artist produced in the last three years: <br /> For example,for visual arts submit a PC-compatible CD or DVD,slides or high quality photographs(5-10 <br /> images);for dance or theater arts submit a PC-compatible CD or DVD,or video tape(3-5 minute sample);for <br /> music and spoken word submit a PC-compatible CD or DVD,or audio tape(1-2 selections);for literary arts <br /> submit a manuscript(10-15 pages). <br /> Label all sample work with artists'/organizations'name,title of work(s),date of work. For visual arts include <br /> sheet with work dimensions, media. Indicate top of image. <br /> AA1�n C.0 t=- 11 .24• 12- M A(LY C 2-I-^V R <br /> Artist Signature Date Typed or Printed Artist Name <br /> INCOMPLETE APPLICATIONS WILL NOT BE FUNDED <br /> Questions? Call 9191968-2011. Delivery address:501 West Franklin Street, Chapel Hill, NC 27516 <br />