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DocuSign Envelope ID:4F42587D-D5B0-4359-B7A1-8246D2FA6E29 <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 /> 5. APPLICATION CHECKLIST (in this order;do not staple, bind, or put into individual folders) <br /> One copy each:(1 sided,81/2"x 11",white paper)and 1 complete electronic copy(in PDF format) <br /> ❑ Application Form,including signatures <br /> ❑ Narrative <br /> ❑ Budget Sheet <br /> ❑ Itemized Budget(if necessary) <br /> ❑ Resumes of key artists and administrators involved in grant funded program(s) <br /> ❑ Organizational Budget for current AND past two fiscal years <br /> ❑ Artist contact list,including names,address, phone numbers,and email(if applicable)of all <br /> artists involved in grant funded activities <br /> ❑ Staff roster 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 /> ❑ Copy of IRS Tax Exemption Letter <br /> ❑ Sample programs, press,or other materials from this or similar past programs <br /> ❑ 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 as.pdf file or hard copy <br /> 6. SIGNATURES <br /> Allan Friedman <br /> Typed or Printed Name—Project Director: I <br /> 11/28/2016 <br /> Signature of Project Director Date <br /> Typed or Printed Name—Authorizing Official: Laura Delauney <br /> 449 11/28/2016 <br /> Signature of Authorizing Offici Date <br /> 919.245.2335 1 200 S.Cameron Street,Hillsborough,NC 27278 I www.artsorange.org <br />