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DocuSign Envelope ID: 183EAA7A-D308-4745-8992-9C32B73F02EE <br /> (1'ART 3: A 7 PLICATII RICHECKLIST <br /> APPLICATION CHECKLIST <br /> Please compile in this order. Do not staple, bind, or put into individual folders or sleeves. Provide one <br /> copy, one sided, 8.5 x 11 white paper. A digital copy of the application is not necessary. <br /> O Application Form, including signatures <br /> O Narrative <br /> O 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 Board of Directors' list <br /> O Copy of IRS Tax Exemption Letter, if applicable <br /> O Sample programs, press, or other materials from this or similar past programs <br /> O Work samples by artist(s), labeled with artists' name, title of work, date of work, produced in <br /> the last three years: <br /> o Visual artists: CD, DVD, or high resolution photographs (8 images per artist MAX), <br /> clearly labeled 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 /> We understand that failure to respond to any of the above items may adversely affect the <br /> consideration of this application. We certify that we are committed to the completion of the proposed <br /> project in compliance with legal requirements and granting procedures. We certify that the information <br /> contained in this application, including attachments and supporting materials, is true and correct to <br /> the best of our knowledge. <br /> NROJECT DIRECTOR (if applicable) <br /> Printed or typed <br /> name: Heather Delisle <br /> Signature: 1.44(irce; 0,1'MA <br /> Date: <br /> AUTHORIZING OFFICIAL (required) <br /> Printed or typed Neil Stutzer <br /> name: <br /> Signature: <br /> Date: <br /> / <br />