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DocuSign Envelope ID: FB3E15D4-0551-47E1-B8EF-3FB7211C37FO <br /> j/ Arts Program Grant - Fa I I <br /> Uv 2014-15 Application Form <br /> ORANGE COUNTY ARTSS 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 /> • Cooperation between organizations and artists. <br /> • Evidence of feasibility of program, community support, and responsiveness to community needs. <br /> • Emerging organizations are encouraged to apply. <br /> 1 Applicant Information <br /> Applicant Name Triangle Youth Ballet <br /> Mailing Address __ PO Box 2067, Chapel Hill, NC 27515 <br /> Daytime Phone 919.932.2676 Fax Number <br /> Email Address triangleyouthballetCa)-g mail.com Web Site www.triangleyouthballet.org <br /> Project Director Lauren Lorentz de Haas Title Founder/Director <br /> DUNS Number 195803619 <br /> 2 Project Director Information <br /> Project Director Home Address 417 Hiqhview Drive, Chapel Hill, NC 27517 <br /> Daytime Phone 919.428.0150(cell) Evening Phone same <br /> Email Address triangleyouthballeta-,gmail.com <br /> 3 Grant Request Summary <br /> Arts Program Grant Request $1,430 <br /> Total Cash Match $1,920 <br /> Total Organizational Budget 2013-2014 $338,266 Past Year <br /> 2014-2015 $339,002 Current Year <br /> 2015-2016 $342,529 Projected for Next Year <br /> Summary Statement for Proposed Uses of Arts Program Grant The Triangle Youth Ballet respectfully <br /> requests a grant in support of its 2015 annual production of The Nutcracker Special Needs Community <br /> Performance at Chapel Hill High School.The grant will be used to underwrite the cost of production <br /> related expenses including costumes, theatre rental, and artist fees. <br /> Questions? Call 9191968-2011. Delivery address: 501 West Franklin Street Chapel Hill, NC 27516 <br />