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DocuSign Envelope ID:3F298E85-795E-4517-9AC0-9FEDA409614B <br /> r�I :/i /r / i ; RPM / <br /> "W mwoim, �" %% /0 ro era �rl,r%/:/�///i ��jii P440'i /%' �i/i �� ����� �i� �,% '� �r/ii I� <br /> / /f l/ r / n % i/ i r/ ��r/ /,, r I/� �j V// <br /> %�if r� l//ii,. %/ro�I%!a, r¢D/r % �/� Diu, a,%I2 ,r,fir, (/ /�/ �il f�,�, <br /> - A NT APPLICATION <br /> o <br /> Applicant: Ephesus Church Rd. Elementary PTA <br /> Date Received: 6/2/17 Date Notified Complete: 6/9/17 <br /> Project Title: Cultural Assemblies 1A- Date: Sept 17-June18 <br /> Use of Funds: Artistic contracts <br /> NCAC Funding Priority: ❑ 1st 2nd ❑ 3rd <br /> NCAC Multicultural Requirement? ❑ Yes Amount $ ❑ No NA/(--'61 <br /> Total number served: 414 students grades k-5 <br /> Community served: <br /> CHCCS - Chapel Hill <br /> Demographics: 30% FRL <br /> CHECKLIST <br /> ▪ Completed application form with ® Budget: FY17-18 <br /> signatures ® Board List <br /> • Narrative ® Tax exemption letter <br /> • Project Budget worksheet EPJAMple publicity <br /> • Resumes of key artists/instructors El Work samples <br /> • Financials: FY15-16 ❑ Letters of support(not required) <br /> ▪ Financials: FY16-17 <br /> AMOUNT REQUESTED: $1937.50 AMOUNT GRANTED: <br /> FINAL SCORE: <br />