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DocuSign Envelope ID: C65FFCA2-OCAA-4476-9EO3-793FA837F635 <br /> ® Arts Program Grant - Fa I I <br /> ® g <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 /> • 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 �y <br /> Applicant Name Fk t.e mbf ®F i 1 c l c. eAg rgo k o 94-(.f M g I y , <br /> Mailing Address q0o 06-E) �t C Ai%�_ &U-, Vc-� 6 <br /> Daytime Phone qt q 96q- .3 00 6 Fax Number q l q _ q6 q - 3® ®S/ <br /> Email Address COAI ' Web Site -W U"' r 6, b/%o, o <br /> Project Director /.Y �YS t_ yy — Title e i'VWXON 1,,20,4aD /VF&A <br /> DUNS Number 0.2- , 660, S Lqq <br /> 2 Project Director Information <br /> Project Director Home Address 161, CafhV9'9 ��e) a APB H&, JVC- <br /> Daytime Phone 1 g 3 1 S^�� Evening Phone gig - !;L/ 309�/ <br /> Email Address �-�L/ q+ z, Cti1 ` <br /> 3 Grant Request Summary <br /> Arts Program Grant Request _'_/ 00 <br /> Total Cash Match ` IS-60 <br /> Total Organizational Budget 2013-2014 4 000 Past Year <br /> 2014-2015 6 Oct O Current Year <br /> 2015-2016 1 6 Q d C) Projected for Next Year <br /> Summary Statement for Proposed Uses of Arts Program Grant RE (Lt&d1°' F&/c Rc�)Y\(-G` <br /> l3 V Th C 6, e - A - C- ' FO iC 71 "AV6 Ole0 /3/ CA <br /> 11ZA-ieAi s' Dtr"i wG AfZt-_-� P,,(e o oil k ii)cal J"cA_P/q><'- <br /> -- COM Vet QJV I.' ! Cfrc_0 tk PC . <br /> Questions? Call 9191968-2011. Delivery address; 501 West Franklin Street, Chapel Hill, NC 27516 <br />