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DocuSign Envelope ID: 183EAA7A-D308-4745-8992-9C32B73F02EE <br /> I <br /> 2 u-it <br /> 0.0 2017-18 <br /> ORANGE COUNTY ARTS co,1/40. GRASSROOTS ARTS PROGRAM <br /> COMMISSION www.nearts.org APPLICATION FORM <br /> PART 1 : APPLICATION ORGANIZATION INFORMATION <br /> Organization Name: Hillsborough Arts Council <br /> Street Address: 102 N Churton St <br /> City: Hillsborough State: NC Zip: 27278 <br /> Phone: 919 643-2500 Website: www.bilisbpcmbarticounqiprq <br /> Authorizing Official Name: Neil Stutzer <br /> Authorizing Official Title: Chair <br /> Authorizing Official Email: <br /> Authorizing Official Phone: 919 698-1859 ns;tutzer@hilisjDo[guqbartsgound <br /> Applicant Race: The organization is multi-cultural Organization EIN: <br /> ORGANIZATIONAL FINANCES <br /> Please attach a complete income and expense statement(an audit may be substituted)for your last fiscal year and <br /> complete operating budgets for the current fiscal year and next fiscal year. Public schools and other large governmental or <br /> community agencies should attach arts program financial information only. Please copy the totals from these attachments <br /> in the spaces below: <br /> Last Year Actual: FYI 5-16 Current Year: FY16-17 Next Year: FYI 7-18 <br /> Actual Income: $84,447 Projected Income: $95,830 Projected Income: $106,500 <br /> Actual Expenses: $104,903 Projected Expense: $99,453 Projected Expense: $106,500 <br /> PART 2: PROJECT INFORMATION <br /> PROJECT DIRECTOR INFORMATION (if different from Authorizing Official) <br /> Project Director Name: Heather Delisle <br /> Project Director Title: Chair of the Artwalk Committee <br /> Street Address: 127 King Charles Rd. <br /> City: Hillsborough State: NC Zip: 27278 <br /> Phone: 919-732-8324 <br /> Email: HjelishOhOlg?prclystertscouciLin <br /> PROJECT SUMMARY <br /> Title of Grant Program or Project: Hillsborough Art Walk Last Fridays <br /> Grant Amount Requested: $1475 <br /> Project Start Date (No earlier than July 1, 2017): July 1, 2017 <br /> Project End Date (No later than June 30, 2018): November 30, 2018 <br /> '2.01/ c;IN,H,,01, I pqr(nEl, AI ph uhuri 1«d <br />