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DocuSign Envelope ID:70E97245-CBDE-4A68-90A8-9FB875F7C092 <br /> 11, <br /> CO/ 2017-18 <br /> ORANGE COUNTY ARTS ARTIST PROJECT GRANT PROGRAM <br /> COMMISSION APPLICATION FORM <br /> PART 1: APPLICATION ORGANIZATION INFORMATION <br /> Artist Name: Dawn Hummer <br /> Street Address: 837 Kenmore Road <br /> City: Chapel Hill State: NC Zip: 27514 <br /> Phone: (512) 924-1136 Website (if applicable): www.saorisong.com <br /> Email: dghummer1@aol.com <br /> PART 2 PROJECT INFORMATION <br /> PROJECT SUMMARY <br /> Title of Grant Program or Project: Freeform weaving for Senior Citizens <br /> Grant Amount Requested: ' 3000 0 0 <br /> Project Start Date (No earlier than July 1, 2017): July 1, 2017 <br /> Project End Date (No later than June 30, 2018): June 30, 2018 <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 P ran Grant Request A moun t - M a t c Matching s Total Expense <br /> Administrative Staff: $0 <br /> A. Personnel Artistic Staff. $ It°° $1200 <br /> Technical/Production Staff. $ $0 <br /> B. Outside Fees and Artistic Contracts: $0 <br /> Services Other contracts: $0 <br /> C. Space Rental $0 <br /> D. Travel Fuel for travel per year $0 <br /> E. Marketing $0 <br /> F. Remaining Project Equipment(looms/yarn) $ I TOO $1800.00 <br /> Expenses <br /> G. Total Cash Expenses $ 1000 $ 3000.00 <br /> 2017 Grassroots Program Grant Application Packet 4 <br />