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DocuSign Envelope ID: 5D512265-377E-4DF8-BOA6-19210828B197 <br /> PART 3: APPLICATION CHECKLIST <br /> APPLICATION CHECKLIST <br /> Please compile in this order Do not staple, bind, or put into individuro folders or sleeve& Provide One copy,, <br /> one sided, 8,5 x 11 white paper. A digital copy of the application is not riecessary, <br /> ED Application berm,including signatures <br /> • Narrative <br /> O Detailed Budget (d necessary) <br /> O Resumes of key artists and adrninistrallors involved in grant fondled program(s,) <br /> O Income and Expense statement for FY15-16 <br /> El Budget or yeer-to-date statement tor FY16-1.7' <br /> O Budget for FY17-18 <br /> O Current Board ot Directors list <br /> O Copy of IRS Tax Exemption Letter, if applicable <br /> El Sample programs, press, or other materials from this or similar past programs <br /> El Work samples by artistic), labeled with artists' name, title of work, date of work, produced in the las,t three yea,rC <br /> o Visual artists: CD, D'i/Di or high resolution pholographs.(8 images per artist MAX), clearly labelled with <br /> dimensions and media and indicate top of image <br /> • Dario()or theater artist CD or DVD, or link to high-quality online video (3-5 minutes) <br /> O Music end spoken word: CD MP3 or link to high-qually online video (3-6 minutes) <br /> o Literary arts: Mariuscript(10-15 pages)submitted as .pdf file or herd copy <br /> PAR'l 4 CERIIF'ICATION <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 is) the completion of the proposed protect in compliance with legal regt,drerrents and <br /> granting propedttres.We certify that the information contained in this application, including attachments and supporting <br /> materials, is true and correct to the best of our knowt Age <br /> Printed or typed name I Wayne''Alson <br /> Signature <br /> trr ii <br /> Date (V <br /> ill „t4._ al_ <br /> 4ricirrItr115511F,7)7, 1,',1 'pi,- <br /> Printed of typed name: Patricia Harris <br /> Signature: <br /> Cirri" 7 <br /> .N.Ai r 1 r <br />