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onnunign Envelope ID:o1sr1F2o-9AaE-*1so-Aaoa-4xoA1n42oc1n <br /> PART APPLICATION CHECKLIST <br /> ^ ^~~~ ^ `�~ ~^^ " ��=~°"�" "~~�� <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/sO0/nBceSG@r/ <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 FYi 5-16 <br /> [] Budget or year-to-date statement for FYI6-17 <br /> [] Budget for FY17-18 <br /> O Current Board of Directors' list <br /> O Copy of IRS Tax Exemption Letter, if applicable <br /> O Sample proQname, pnaoa, 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 the last three years: <br /> o Visual artists: CD. OVD, or high resolution photographs (8 images per artist MAX), clearly labeled with <br /> dimensions and media and indicate top of image <br /> o Dance or theater artist: CD or OVD, 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 /> PART CERTIFICATION <br /> " ��" " " 4: ��°�" � " "" °=°��" �=-"~ <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 /> PROJECT'DIRECTOR(If applicable) <br /> Printed or typed name: Erika Foster <br /> Signature: <br /> 004Y^� <br /> Date: <br /> wi07/1/1?-- <br /> "AUTHORIZING OFFICIAL(required) , // // ;;„, 7,// <br /> Printed or typed name: Ashley Slaughterbeck <br /> Signature: I1,04 1°4 Q I <br /> Ai °_ \ <br /> yl <br /> Date: a��� ° ^/� y�"� <br /> �/ � � � � <br /> � ° <br /> 2017Omw m0,,Program Gun|xpp|i< olio; Pocke1 <br />