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DocuSign Envelope ID:66E45008-FB1D-4049-B8DE-1C00A1D64C3E <br /> I /de <br /> 0,0 2017-18 <br /> COUNTY ARTS ARTIST PROJECT GRANT PROGRAM <br /> ORANGE <br /> COMMISSION APPLICATION FORM <br /> PART 1 : APPLICATION ORGANIZATION INFORMATION <br /> Artist Name:mane rossettie, Level LLC <br /> Street Address:1465 Smith Level Rd. <br /> City:Chapel Hill State:NC zip:27516 <br /> Phone:919.590.5853 Website(if applicable): <br /> Email:Leveltietreat(g.iGmail.com <br /> PART 2: PROJECT INFORMATION <br /> PROJECT SUMMARY <br /> Title of Grant Program or Project:Nicholas Chatfield-laylor: Wooden Igloo Sculpture & Sound Installation <br /> Grant Amount Requested:$3000.00 <br /> Project Start Date(No earlier than July 1,2017): 1 BD <br /> Project End Date(No later than June 30,2018): EH) <br /> PROJECT NARRATIVE <br /> Please attach a narrative providing the information requested below for the project you propose. Please be as concise <br /> and specific as possible: <br /> 1. Summary of the proposed project-what will you do,where will it be performed or displayed,when the preparations <br /> and public component take place,any organizational partners. <br /> 2. Community impact-describe the project's public component, how many people and what populations will be <br /> impacted. <br /> 3. Artist experience—include a brief description of your similar arts projects in the past, if applicable. <br /> PROJECT BUDGET <br /> Please provide a projected budget for your proposed project utilizing the format below. You may attach an additional <br /> detailed budget if necessary, but the tables below must be filled out. Please see the attached Glossary of Budget Terms <br /> for more information. NOTE:Matching funds are not required but may be encouraged depending on the project. If you <br /> have additional funding sources,please include them in the chart below. <br /> PROJECT EXPENSES Explanation Grant Request Amount ÷Matching Funds =Total Expense <br /> Administrative Staff: $(Volunteer) $ <br /> A. Personnel Artistic Staff: $500 $500 $1000 <br /> Technical/Production Staff: $ $(Volunteer) $ <br /> B. Outside Fees and Artistic Contracts: <br /> Services Other contracts: <br /> C. Space Rental Three weeks $1000 $1000 $2000 <br /> D. Travel Airfare, local transport $500 $500 $1000 <br /> E. Marketing Jebsite/event promotior $500 $500 $1000 <br /> F. Remaining Project Supplies $500 $500 $1000 <br /> Expenses <br /> G. Total Cash Expenses $3000 $3000 $6000 <br /> I I (III I ( <br />