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DocuSign Envelope ID:F7163211-DB22-463E-994F-9511800DB63B <br /> 1 1, <br /> FALL 2016 <br /> ORANGE COUNTY ARTS <br /> ARTS IN EDUCATION GRANT <br /> COMMISSION APPLICATION FORM <br /> 1. APPLICANT INFORMATION <br /> Applicant Name Nancy Zeman/Chapel Hill-Carrboro Public School Foundation <br /> Mailing Address P. O. Box 877, Carrboro, NC 27510 <br /> Daytime Phone 919-967-8211 x28376 Email Address nzeman @chccs.kl2.nc.us <br /> Web Site www.publicschoolfoundation.org DUNS Number 182048145 <br /> 2. PROJECT DIRECTOR INFORMATION <br /> Project Director Name Nancy Zeman Title Program Services Manager <br /> Home Address: 106 Quailview Drive, Chapel Hill, NC 27516 <br /> Daytime Phone 919-967-8211 x28376 Evening Phone 919-225-0075 <br /> Email nzeman @chccs.k12.nc.us DUNS Number 182048145 <br /> 3. GRANT REQUEST SUMMARY <br /> Arts Program Grant Request $ 500 Total Cash Match $ 500 <br /> Total Organizational Budget Past Year $306,880 <br /> (Including PTSA/Cultural Current Year $316,700 <br /> Enrichment/Arts Program) Projected for Next Year $310,000 <br /> Summary Statement for Proposed Uses of Arts Program Grant: The Skoog music project will promote <br /> independent involvement in music activities, allowing students with significant disabilities to play <br /> music on their own--perhaps for the first time in their lives! <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 /> is <br /> 919.245.2335 1 200 S.Cameron Street, Hillsborough,NC 27278 I www.artsorange.org <br />