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onnunign Envelope ID: 1EeFoAnnF3r1-4rFo*oon-2owoFoone4Ar <br /> - - -- ----- ---- -- ---------- ---------- -- -- - ------ - ---- <br /> PART 3: 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 is not necessary. <br /> [] Application Form, including signatures <br /> [] Narrative <br /> [] <br /> Detailed Budget(if necessary) <br /> [] Resumes of key artists and administrators involved in grant funded program(s) <br /> [] Income and Expense statement for FYi 5-16 <br /> [] Budget or year-to-date statement for FYI 6-17 <br /> [] <br /> Budget for FY17-18 <br /> [] Current Board of Directors' list <br /> [] <br /> Copy of IRS Tax Exemption Letter, if applicable <br /> [] Sample proQnoms, pneas, or other materials from this or similar past programs <br /> [] <br /> 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. DVD, 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 DVD, 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 4: CERTIFICATION <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 p ject 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: Evan Feldman <br /> Signature: <br /> _ ~ - -�� <br /> Date: May 15, 2017 <br /> AUTHORIZING OFFICIAL(required) <br /> Printed or typed name: Merida Negrete <br /> Signmtuoa: \�` ( \ U A-c2_ <br /> " ~��~-~~~~_-�^ <br /> Date: May 15, 2017 <br /> 2OlrG,00aokPmQ/omGmn0xpp|ico|ionPock*| <br />