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DocuSign Envelope ID: CCBBE1A9-7380-4ECB-80BB-F4A709DCB94C <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 /> 12' Application Form, including signatures <br /> I ' Narrative <br /> 17 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 /> L.- ❑ Artist contact list, including names, address, phone numbers,and email (if applicable)of all <br /> k94-1 artists involved in grant funded activities <br /> �0,k Er Staff roster with position title(s) <br /> No 12/Board contact list, including names,address, phone numbers,and email (if applicable) of <br /> organization's board of directors <br /> ` l' Copy of IRS Tax Exemption Letter <br /> Ll/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 /> N` - last three years: <br /> Li r\ o Visual artists:CD, DVD,or high resolution photographs(5-10 images).Clearly label each <br /> �� �A(t° "` piece with dimensions and media and indicate top of image <br /> \V _ 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 /> Typed or Printed Name-Project Dire tor: Dr, Ca((t Li I- ( <br /> Signature of Project Director Da e <br /> Typed or Printed Name-Authorizing Official: ✓i, i 116 .0 I -�,4rr4 <br /> Signature of Authorizing Official Date <br /> 919.245.2335 1 200 S.Cameron Street,Hillsborough,NC 27278 www.artsorange.org <br />