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DocuSign Envelope ID: CF1E5821-41D3-41 CA-BE86-7063BD8D1470 <br /> 11> <br /> FALL 2016 <br /> ORANGE COUNTY ARTS ARTS IN EDUCATION GRANT <br /> COMMISSION APPLICATION FORM <br /> 1. APPLICANT INFORMATION <br /> Applicant Name e o (\ o �� � �� (6.4 -� <br /> Mailing Address 11°001 1-1:9 c..(40,04 tZd• Cirep( : , tJ 2-7516 <br /> Daytime Phone .% • TjG(-Z4 06 . I ts°' Email Address hit irt'Jo�� 5•(/JZ• >C.05 <br /> Web Site ChkiVf3.CJ •WI— AC- U5 DUNS Number I 1 <br /> 2. PROJECT DIRECTOR INFORMATION <br /> Project Director Name ..i("Lae l (' 4 Title e 4& IJ&Vt ./ z fed <br /> Home Address: 14 LYS Ave v',Plum. <br /> Daytime Phone ef t ' S•t"• 14-14 (() Evening Phone ' 5 •• 714143 Cce <br /> Email f ijt c . (4.12. • C• US DUNS Number l <br /> 3. GRANT REQUEST SUMMARY / <br /> Arts Program Grant Request $ /OQ . O Total Cash Match $ !®®0 • " <br /> Total Organizational Budget Past Year 31 e <br /> (Including PTSA/Cultural Current Year fi r & <br /> Enrichment/Arts Program) Projected for Next Year f 4, <br /> Summary Statement for Proposed Uses of Arts Program Grant: Ed /t 1': <br /> S ' h a( folk. co- Wale- torl (24 5e5s,-- <br /> peicrl ptitz,vwc4Aft.e. c.i.NA 14 ( k" 1,41C, 54001 . <br /> 4. NARRATIVE <br /> Write a description (no more than three pages, single spaced)that describes the following under <br /> separate subheadings: <br /> • School profile—a brief overview of population and services. <br /> • School's arts programs—a brief list. <br /> • Proposed uses of grant funds—description, including location, date, artists involved. Include <br /> information concerning whether you have undertaken similar activities in the past. Include <br /> approximate number of audience per program;geography of audience; mix of race,ethnicity, <br /> age,and gender. Discuss how arts program will be integrated into the curriculum. <br />