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DocuSign Envelope ID:B3B563FD-6D63-4031-A74C-538395FA5A15 <br /> I 4/ <br /> Z > <br /> COO ("It 2017-18 <br /> ORANGE COUNTY ARTS co'NN" GRASSROOTS ARTS PROGRAM <br /> COMMISSION www.ncarts.org APPLICATION FORM <br /> PART 1 : APPLICATION ORGANIZATION INFORMATION <br /> Organization Name: New Hope Elementary(Orange County Schools) <br /> Street Address: 1900 New Hope Church Road <br /> City: Hillsborough State: NC 27514 <br /> Phone: (919)942-969 Website: http://www.orangecountyfirst.com/nh/ <br /> Authorizing Official Name: Dr. Lisa Napp <br /> Authorizing Official Title: Director, Elementary Education/Pre-K/Title 1 and ESL, Orange County Schools <br /> Authorizing Official Phone: 919-732-8126 Authorizing Official Email: Iisa.napp©orange.k12.nc.us <br /> Applicant Race: White Organization EIN: <br /> ORGANIZATIONAL FINANCES <br /> Please attach a complete income and expense statement(an audit may be substituted)for your last fiscal year and <br /> complete operating budgets for the current fiscal year and next fiscal year. Public schools and other large governmental or <br /> community agencies should attach arts program financial information only. Please copy the totals from these attachments <br /> in the spaces below: <br /> Last Year Actual: FY15-16 Current Year: FY16-17 Next Year: FY17-18 <br /> Actual Income:$69,500 Projected Income: $67,500 Projected Income: $89,500 <br /> Actual Expenses: $69,500 Projected Expense:$ 67,500 Projected Expense: $89,500 <br /> PART 2: PROJECT INFORMATION <br /> PROJECT DIRECTOR INFORMATION if different from Authorizing Official) <br /> Project Director Name: Ambra Wilson <br /> Project Director Title: Principal, New Hope Elementary <br /> Street Address: 1900 New Hope Church Road <br /> City: Hillsborough I State: NC IZip: 27514 <br /> Phone: (919)942-9696, ext 4400 FEmail: ambra.wilson@orange.k12.nc.us <br /> PROJECT SUMMARY <br /> Title of Grant Program or Project: Artist in Residence Program (four OCS Title 1 Schools) <br /> Grant Amount Requested: $8,000 <br /> Project Start Date(No earlier than July 1, 2017): August 15,2017 <br /> Project End Date (No later than June 30, 2018): June 1, 2018 <br /> SCHOOLS ONLY: <br /> Are you booking your artists through The ArtsCenter's Arts in Schools Program? X YES 0 NO <br /> rwie, clm /1,1,h 11 ,1 <br />