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DocuSign Envelope ID:AD99FE27-E625-45CC-B353-AEE3ADA2F2DA <br /> I <br /> r <br /> I <br /> „A«. APPLICATION <br /> APPLICATION CHECKLIST <br /> Please compile in this order. Do not staple, bind, or put into individual folders or sleeves. Provide one copy, <br /> one sided, 8,5 x 11 white paper. A digital copy of the application is not necessary. <br /> i <br /> Le Application Form, including signatures <br /> Ca"Narrative <br /> 0 Detailed Budget(if necessary) <br /> UK Resumes of key artists and administrators involved in grant funded prograr'n(s) <br /> [],"Income and Expense statement for FYI 5-16 <br /> L" Budget or year-to-date statement for FYI 6-1 7 <br /> GK Budget for FY1 7-16 <br /> Current Board of Directors" list <br /> ED,'Copy of IRS Tax Exemption Letter, if applicable <br /> ample programs, press, or other materials from this or similar past programs <br /> Work samples by artist(s), labeled with artists" name, title of work, date of work, produced in the last three years: <br /> Visual artists; CD, DVD, or high resolution photographs (6 images per artist MAX), clearly labeled with <br /> 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 words 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 /> PART 40 CERTIFICATION <br /> We understand that failure to respond to any of the above items may adversely affect the consideration of this application. <br /> We certify that we are committed to the completion of the proposed project in compliance with legal requirements and <br /> granting procedures.We certify that the information contained in this application, including attachments and supporting <br /> materials, is true and correct to the best of our knowledge. <br /> I IQJEC7 DIRECTOR.�.___ <br /> Printed or typed narne: <br /> Signature: <br /> AU"t"kfiCMRNIhNIa CIP.._ w�..�.,w.,� ..._.. ., .,.,..w.. .b�.._w,m.. .. <br /> Printed or typed name: Elia th Lewis Corley <br /> Signature: <br /> ...Date:......,.,.__....... <br /> .w.. ..............�.........wM�„;;�w... <br /> Y_..._.....,v......,.wwm,,.., <br /> 7 <br /> u1. <,rar,-i�rYff;h, r'p`fu r iuila,�,,.��r, r1�ri i a r ,r <br />