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Orange County Arts Commission Powered by Submittable <br />Legal Name of <br />Applicant Carl os Gonzal ez Garci a <br />by carlos gonzalez in Orange County Arts <br />Support Fund (INDIVIDUALS ONLY) - Round 4 <br />311 BARTLETT CIRCLE <br />HI LLSBOROUGH, North Carolina <br />27278 <br />NORTH CAROLI NA <br />United States <br />919 5372176 <br />ncmosaics@gmail.com <br />11/17/2020 <br />id. 18253112 <br />Original application 11/17/2020 <br />Artist Name, if <br />different than legal <br />name <br />n/a <br />Email address ncmosaics@gmail.com <br />Do you reside in <br />Orange County, <br />North Carolina? <br />Yes <br />Home address: <br />Street <br />311 BARTLETT CIRCLE <br />Home address: City HILLSBOROUGH <br />Home address: Zip <br />Code <br />27278 <br />Please select the <br />scenario(s) that best <br />describe your <br />situation: <br />You are a professional artist, whose source of income is through <br />your art <br />How would you best <br />your profession? <br />Mixed Media Artist <br />Other than your <br />work, what sources <br />of household income <br />do you currently <br />have? <br />I hav e a part-time job that I work 20 hours for Amazon. <br />It comes out to be 1000 dollars. <br />DocuSign Envelope ID: 22CC84C4-7ECF-49EF-A052-A699D35D2CC4