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DocuSign Envelope ID: 1E8FDA35-F3F1-47FD-88D3-2C06F3C9B4A7 <br /> ifif CA8 <br /> 0 <br /> 11/#4 4d."Nt 41, o <br /> z *It > <br /> 0.0 2017-18 <br /> c., <br /> ORANGE COUNTY ARTS GRASSROOTS ARTS PROGRAM <br /> COMMISSION www.ncarts.org APPLICATION FORM <br /> PART 1 : APPLICATION ORGANIZATION INFORMATION <br /> Organization Name: Chapel Hill Philharmonia <br /> Street Address: 104 Fieldstone Court <br /> City: Chapel Hill State: North Carolina Zip: 27514 <br /> Phone: 919-968-6418 Website: www.chapelhillphilharmonia.org <br /> Authorizing Official Name: Merida Negrete <br /> Authorizing Official Title: Board President <br /> Authorizing Official Phone: 919-740-8656 Authorizing Official Email: mn2628@gmail.com <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: $23353 Projected Income: $19200 Projected Income: $16900 <br /> Actual Expenses: $16736 Projected Expense: $20486 Projected Expense: $16180 <br /> PART 2: PROJECT INFORMATION <br /> PROJECT DIRECTOR INFORMATION (if different from Authorizing Official) <br /> Project Director Name: Evan Feldman <br /> Project Director Title: Guest Conductor <br /> Street Address: 23203 Spring Meadow Drive <br /> City: Chapel Hill State: North Carolina Zip: 27517 <br /> Phone: 919-914-0212 Email: evanfeldman@unc.edu <br /> PROJECT SUMMARY <br /> Title of Grant Program or Project: Children's Concert With "The Composer Is Dead" <br /> Grant Amount Requested: $1250 <br /> Project Start Date(No earlier than July 1, 2017): September 7, 2017 (first rehearsal) <br /> Project End Date (No later than June 30, 2018): October 22, 2017 (concert date) <br /> SCHOOLS ONLY: <br /> Are you booking your artists through The ArtsCenter's Arts in Schools Program? 0 YES X NO <br /> 2m/ (,rc SrOC.)0 HnC/1( 2oim A p )(I( (4,H H )) <br />