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DocuSign Envelope ID: D9AFB279-4BB8-4BEO-B6B5-342497BC18DB <br /> PART 3: AppLicATIoN cHEcKLIST <br /> APPLICATION CHECKLIST <br /> Please compile in this order. Do not staple, bind, or put into individual folders or staev;s. Provide one copy, <br /> one sided, 8.5 x 11 white paper. A digital copy of the application is not necessary, <br /> O Application Form, including signatures <br /> CI Narrative <br /> O D;tailed 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 artists), labeled with artists' name, title of work, date of work, produced tri the last thiree years <br /> 0 Visual artists. CD, DVD„ or high resolution photographs(8 images per artist MAX), clearly labeed l with <br /> dimensions and media and indicate top of image <br /> o Dance or theater atiist, CD or EDVD, or link to high-quailly online video (3-5 minutes) <br /> it Music and spoken word: CD „ IMP or link to high-quality online video(3-5 minutes) <br /> • Literary arts, Manuscript(10-15 pages) submitted as .pdf file or hard copy <br /> PART 4: cERTIFICATION <br /> We understand that are to respond to any of the above items may adversely affect the consideration of this application. <br /> We certify that we ale committed to the completion of the o <br /> prop, sed project in compli;nce 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 It;st of our knowledge. <br /> PriOJECT DIRECTOR (if appitc <br /> Printed or typed name, <br /> IJ <br /> Signature: <br /> r Ar <br /> Date: di- 2 z <br /> AUTHORIZING OFFICIAL(required) <br /> Printed or typed name: -A <br /> - ' <br /> signature: <br /> ( <br /> Date: <br /> „ „ <br />