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/ Artist Project Grant - Fall <br /> 1 --N/ <br /> G#; 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 Michael Roy Layne dba Legacyworks <br /> Mailing Address 3803 Carnegie Lane Raleigh NC 27612 Studio: 135 S Main St., Warrenton NC 27589 <br /> Daytime Phone 919.616.8417 Fax Number 919.571.8286 <br /> Email Address la ne�CoNegacvworks.com Web Site www legacyworks greglonescto (under construction) <br /> DUNS Number <br /> 2 Grant Request Summary <br /> Arts Program Grant Request $1,000.00 Total Cash Match $2,410.00 <br /> Summary Statement for Proposed Use of Arts Program Grant Artist fee for creation and installation of an <br /> illuminated public environmental sculpture Chrysalis+Drago(n)Doctrine on 2nd story of fagade at 109 E. <br /> Franklin St Chapel Hill NC (Frank Gallery &The Clothing Warehouse) in association with the Downtown Arts <br /> Program, month of February 2013. <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, 8 112"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'lor imvd a io s' name, title of work(s), date of work. For visual arts include <br /> sheet v�ith ork dime medi . Indicate top of image. <br /> l!, <br /> r' 11.27.12 Michael Roy Layne <br /> -�, s ig ure Date Typed or Printed Artist Name <br /> f <br /> L'� <br />