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DocuSign Envelope ID:0E33E5E7-2F9B-4F3C-9COD-95D21AC52620 <br /> f^^ <br /> 5. 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 /> 15 Application Form, including signatures <br /> l ' Narrative <br /> 12' Budget Sheet <br /> ❑ Itemized Budget(if necessary) <br /> , r a Resumes of key artists and administrators involved in grant funded program(s) <br /> . <br /> "1 �. ICY Organizational Budget for current AND past two fiscal years <br /> N E' Artist contact list, including names, address, phone numbers, and email (if applicable) of all <br /> artists involved in grant funded activities <br /> Ca' 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 /> ❑ Copy of IRS Tax Exemption Letter, if private school <br /> ❑ Sample programs, press, or other materials from this or similar past programs <br /> l" 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 C'y <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: ' AVS ft <br /> 12-1 31 iF <br /> L ar G <br /> E� <br /> Sign re of Project Director g�) Date w. <br /> Typed or Printed Name—Authorizing Official: A/At M. e-Isis' <br /> 12/05/1k <br /> Signat,,lfe of Authorizing Official I Date <br /> is <br /> is <br /> is <br /> 9: .t. J2_:3:i ai; >,UN-Hi c.;\i(t.. . Fl i wtA+v,, €.S.i€7 {_ �:?ff; <br /> I!' <br />