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DocuSign Envelope ID:8359632A-C43D-4832-B2EC-ED419B356126 <br /> I <br /> /�, FALL 20 16 <br /> ARTIST PROJECT GRANT <br /> ORANGE COUNTY ARTS APPLICATION FORM <br /> COMMISSION <br /> 1. ARTIST INFORMATION <br /> Applicant Name CL2C-4-6r LAbbay4 <br /> Mailing Address L MQ t�j ��- 1 br[27 G � Lei 1 cw OIL 3L( <br /> Daytime Phone G) • (alb Email Address Car--i-er. .Ci/l <br /> Web Ste c4r E,PArt1 bbalyd • CO DUNSNumber 1910 13- <br /> G <br /> 2. GRANT REQUEST SUMMARY <br /> Artist Project Gant Request $ 1,000 Total Gish Match $ I f0°6 <br /> Title of proposed grant program or project: F • iii a 11 / c. r A t4 <br /> -fro V o - s <br /> 3. NARRATIVE <br /> Write a description(no more than three pages, single spaced)that describes the following under <br /> separate subheadings: <br /> • Proposed project—what will you do,where will it be performed or displayed,when will the <br /> preparat ions and public component take place, list any organizational partners. <br /> • Community impact—describe the project's public component, how many people will be <br /> impacted. <br /> • Artist experience—indude a brief description of your similar arts projects in the past. <br /> 4. APPLICATION CHECKLIST (in this order;do not staple, bind,or put into individual folders) <br /> One copy: 1 sided, 81/2' x 11",white paper <br /> V Application Form, induding signature <br /> Narrative <br /> 21 Budget Sleet <br /> p' Itemized Budget (if necessary) <br /> Fbsumesof artist(s) <br /> a Sample programs press, or other materialsfrom this or similar past programs <br /> A Sample work by artist (labeled with artists'name,title of work, date of work)produced <br /> in the last three years: <br /> FIO Visual arts:CD, DVD,or high resolution photographs(5-10 images). Clearly label <br /> each piece with dimensions and media and indicate top of image <br /> Dance/theater: CD or DVD, or link to high-quality online video(3-5 minutes) <br /> Musclspoken word:CD, M P3 or link to high-quality online video(3-5 minutes) <br /> 'terary arts: Manuscript (10-15 pages)submitted as.pdf file or hard copy <br /> Artist Sgnatu e Date Typed or Printed Artist Name <br /> 919.245.2335 1 200 S. Cameron Street,Hillsborough, NC 27278 I www.artsorange.org <br />