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DocuSign Envelope ID:71 71A1 F5-8FF6-4COD-9E6C-2224164C181 D <br /> 5. APPLICATION CHECKLIST (in this order;do not staple,bind, or put into individual folders) <br /> One copy:l sided,81/2"x 11",white paper <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 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 /> ❑ 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: A 1 d V 11 1€ h <br /> Signat a of Project Director Elate <br /> L4& blikua <br /> Typed or Printed Name—Authorizing Official: <br /> it/ AP <br /> Signature of Authorizing Official Date <br /> 919 245 2335 1 200 5.Cameron Street, Hillsborough,NC 27278 I war✓=i.artsoronge.org <br />