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DocuSign Envelope ID:914D8A8E-A05B-425D-A60B-D2D4C2FE5054
<br /> PART 3. APPLICATION CHECKLIST
<br /> .
<br /> API!L1CATION CHECKLIST
<br /> 'it:t1 in this order, Do not staple bind, or put into individttal fotders or sleeves. Provid; one copy,
<br /> Piease comps , , t
<br /> one sided, 8.5 x 11 white paper. A di!fital copy of the ar),nlicatlein is not necessary.
<br /> O Application Form, irtcluding signatures
<br /> O Narrative
<br /> ' Detailed Budget (if necessary)
<br /> O Resumes of key artists and administrators involved in grant funded program(s)
<br /> O Income and Expense statement for FY15-16
<br /> O Budget or year-to-date statement for FY16-17
<br /> O Budget for FY17-18
<br /> O Current griarci of Directors list
<br /> ri Copy of IRS Tax Exemption Letter, if applicriblo
<br /> 1 1 Sample programs, press, or other materials from this or sintilar past programs
<br /> El Work samples by artists), labeled,wilt artists' name, title of work, date of work, produced in the last three .1111'''
<br /> yeal
<br /> or Visual artists: CD, DVD,or high resolution photographs Q images per artist MAX), clearly labeled wi
<br /> dimensions and media and indicate top of irnage
<br /> Dance or theater artist: CD or DVD, Of tifik to high-quality online video (3.5 minutes)
<br /> Music and spoken word: CL) , MR3 or link to high-dila lity 0'rtialiii, ,' video (3-5 minutes)
<br /> r) Literary arts: Manuscript("10-15 pages) submitted as .pdf hie or hard copy
<br /> 11 PART 4 CERTIFICATION
<br /> We understand that failure to respond to any of the above items may adversely aft-ct the consideration of this Initpscialircidat
<br /> We certify that we are corrirTillited to the completion of the prone.sed project in cornoilande with legal requirements .
<br /> granting procedures. We certify that the information contained in this apptiorttion, including attachments and supporimt
<br /> materials, is true and correct to the best of our knowledge,
<br /> PROJECT 1:111RECTO If apiplie,'Ittl,
<br /> Printed or typed name:
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<br /> Signature:
<br /> Date:
<br /> ALITHOPIIZING 'OFFICIAL(requi ,Jei)
<br /> ,r,,,Printed or typed name: Marlon Torres
<br /> Signatitre:.
<br /> Date:
<br /> _•_., , .. vanwoommunwrawmgrtruffner rrmm..YrrM..........""f"'".
<br /> 'It
<br /> May ,,j3
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