Orange County NC Website
DocuSign Envelope ID:955CF8D2-2C10-4E40-BC25-542ECC04AE02 <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 /> ❑ 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 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 <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 as.pdf file or hard copy <br /> 6. SIGNATURES <br /> Typed or Printed Name—Project Director: Mary Stone Lamb <br /> Y ^^//,,,,4�c'� December 5, 2016 <br /> Signature oject Director Date <br /> Typed or Print- _ i :me—Authorizing Official: Gordon Jameson <br /> / ,��,�,,,, -� December 5, 2016 <br /> Signature/6i A itasrizing Official Date <br /> / <br /> 919,245.2335 1 200 S.Cameron Street,Hillsborough,NC 27278 I www.artsorange.org <br />