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j/ General Arts Support Grant <br /> 2014-15 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 /> Evaluation Criteria <br /> • Artistic merit of program. <br /> • Populations served—impact for geographic&traditionally under-served populations. <br /> • Feasibility of proposed activity&effectiveness in fulfilling applicant's mission. <br /> • Organizational strength of applicant. <br /> • Cooperation between organization and artists. <br /> • Evidence of community support and responsiveness to community needs. <br /> 1 Applicant Information ((�� p <br /> Applicant Name DEEP DIS-4 THEATER, COMPANY <br /> Y <br /> Organization Mailing Address PO 8oX 13SZ I CNAPEL �ILL I NC 27S157 <br /> Daytime Phone 01 1 9— `(&00—J 5 J S7 Fax Number IVr/A <br /> Email Address I Al FFOe DEEMISWIREATER-OKWeb Site 3dW)y.deeD�lS„ hAMftC;Of"q <br /> Project Director T A V L- 1=P.6 L L 1 C K t�Title A� ai ST i C b RECToI� ,J <br /> DUNS Number 114-e O o� J s e <br /> 2 Project Director Information (Director or Chair must be Project Director for the General Support grant category <br /> t ; <br /> Project Director Home Address 109 1 EA� N CT. C AAML �1LL. IY C Z 75)6 <br /> Daytime Phone oJ i 1 Evening Phone SAME <br /> Email Address PA ULT=AELC.IC fee GMA1l,XOM <br /> 3 General Support Request Summary <br /> General Support Grant Request <br /> $5©oO <br /> Total Cash Match :15000 w (Match may not include funds from the North Carolina Arts Councii,, <br /> Total Organizational Budget 2012-2013 31_501 47 1 <br /> 2013-2014 V;Z <br /> 2014-2015 _SlHt:�- 000 crphT E p� <br /> Summary Statement for Proposed Uses of General Support Grant+OMPATI NG S V PPORT OF 0(/K MTN <br /> 5;nAsoM wi4Ic14 WI�� INCLOVE 'A KIo LIKE 3Are IT-Ne. LAnDIMG �PREAIMR <br /> ouR ytu AWVAL NEr( h ,Y V1roMflPPP EY'S DID. ANb �Ti4E LiA& <br /> Budget Sheet—See Page Three <br /> Questions? Call us at(919)968-2011 - Deliver Application to:501 West Franklin Street, Chapel Hill, NC <br />