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DocuSign Envelope ID:0E33E5E7-2F9B-4F3C-9COD-95D21AC52620 <br /> 11 <br /> Cc,/ <br /> FALL 2016 <br /> ORANGE COUNTY ARTS IN EDUCATION GRANT <br /> ARTS <br /> COMMISSION APPLICATION FORM <br /> 1. APPLICANT INFORMATION <br /> Applicant Name 5- / 0 <br /> Mailing Address et t 1,5 sue.' ' ! SC..At,er d. C(t& c "'M <br /> Daytime Phone i9 - 9 (1 13 '1 3 Email Address W i a$ • ft'I . &/$ <br /> Web Site clicts $ DUNS Number / <br /> 2. PROJECT DIRECTOR INFORMATION <br /> Project Director Name Zat Wit iv'S-latiet Title PTA eivii-vveat.t, - <br /> e <br /> Home Address: 1 t &i ( V <br /> c� <br /> Daytime Phone ,119 — 6,10— 3 2iS Evening Phone <br /> Email to VIA. t • C,0 DUNS Number N <br /> 3. GRANT REQUEST SUMMARY <br /> Arts Program Grant Request $ 0 0 () . 00 Total Cash Match $ L i <br /> Total Organizational Budget Past Year 3 5 ° 0 <br /> (Including PTSA/Cultural Current Year 44, 5 0 <br /> Enrichment/Arts Program) Projected for Next Year ii 50 0 <br /> Summary Statement for Proposed Uses of Arts Program Grant: We- WV 1 d it ke, <br /> rOV tit, 01/4 i 5 d vl vvtt VA,ii 1 et t vt5 LAAAJ vvliv5 <br /> 51A-o? Ittt- ,, , . . t . <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 /> 9 i`I.:45.29 200 a.�.C.1:2'if;P'r`,n J1P::.'`' [i11'Ss:(�'ii i;wl vt.. 1:/2'8 i'. <br />