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DocuSign Envelope ID: E2E21521-71A5-4711-A40C-EC691AF3B3A7 <br /> 5. APPLICATION CHECKLIST (in this order;do not staple, bind, or put into individual folders) <br /> One c9py:l sided,81/2"x 11', white paper <br /> ,Application Form, including signatures <br /> d Narrative <br /> tie Budget Sheet <br /> qa, /Itemized Budget(if necessary) <br /> �1f Resumes of key artists and administrators involved in grant funded program(s) <br /> ©r Organizational Budget for current AND past two fiscal years <br /> 1- Artist contact list, including names, address,phone numbers,and email(if applicable)of all <br /> artists involved in grant funded activities <br /> Si 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 /> Y\IQ❑,,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 /> v6 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: S(o bIiii �Owl <br /> S20114)• fe,11)-(13(--) 71 cY ib <br /> Signature of Project Director Date <br /> Typed or Printed Name—Authorizing Official: athl ae,1 Cat k <br /> 40.01/04 CAA:ACINLOS- 1 - 261 - I C <br /> Signature of Authorizing Official Date <br /> 919.245299'5 I Ci S.Comet on So i lsborough NC 27978 www orfsorango.org <br />