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DocuSign Envelope ID: CF1E5821-41D3-41CA-BE86-7063BD8D1470 <br /> 5. APPLICATION CHECKLIST (in this order;do not staple, bind, or put into individual folders) <br /> One copy:1 sided,81/2"x11', white paper <br /> ® Application Form,including signatures <br /> If( Narrative <br /> g Budget Sheet <br /> RI' Itemized Budget(if necessary) <br /> 0' Resumes of key artists and administrators involved in grant funded program(s) <br /> d Organizational Budget for current AND past two fiscal years <br /> d Artist contact list, including names,address, phone numbers,and email (if applicable)of all <br /> artists involved in grant funded activities <br /> Staff roster of all school art& music teachers with position title(s). <br /> Board contact list, including names, address, phone numbers, and email (if applicable)of <br /> organization's board of directors <br /> d Copy of IRS Tax Exemption Letter, if private school <br /> RI',Sample programs, press,or other materials from this or similar past programs <br /> Et Sample work by artist(labeled with artists' name,title of work, date of work) produced in the <br /> last three years: <br /> o Visual artists: CD, DVD, or high resolution photographs (5-10 images). Clearly label each <br /> piece with dimensions and media and indicate top of image <br /> o Dance or theater artist: CD or DVD, or link to high-quality online video(3-5 minutes) <br /> o Music and spoken word: CD, MP3 or link to high-quality online video(3-5 minutes) <br /> o Literary arts: Manuscript(10-15 pages)submitted by.pdf or hard copy <br /> 6. SIGNATURES <br /> Typed or Printed Name—Project Director: M.` Ci I riArt <br /> //tidat- / ' ,62/6M' , <br /> Signature of Project Direct r Date <br /> Typed or P ted 'ame—Authorizing O ficial: rk U V ■ a4 /V <br /> if <br /> gyr Alp /09-_-/k/ 1r- <br /> • re of , i thorizing Offici;0I Date <br /> i <br /> r <br /> e,. <br /> r <br /> 1=' <br />