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Orange County Arts Commission Powered by Submittable <br />Name of organization <br />or business Art Therapy Insti tute of NC <br />by Bridget Pemberton-Smith in NC CARES for the <br />Arts Grant Program <br />200 North Greensboro St. <br />Suite D-6 <br />Carrboro, North Carolina <br />27510 <br />United States <br />9193816068 <br />bridgetpemsmith@gmail.com <br />10/30/2020 <br />id. 18057427 <br />Original application 10/30/2020 <br />ORGANIZATION/BUSINESS <br />INFORMATION <br />n/a <br />Date organization <br />was formed <br />09/18/2009 <br />Authorizing Official Bridget Pemberton-Smith, Executiv e Director <br />Authorizing Official - <br />phone number <br />9196052081 <br />Authorizing Official - <br />email <br />bpemberton-smith@ncati.org <br />Grant Manager - <br />name (if different <br />from Authorizing <br />Official) <br />n/a <br />Grant Manager - <br />phone (if different <br />from Authorizing <br />Official) <br />n/a <br />Grant Manager - <br />email (if different <br />from Authorizing <br />Official) <br />bridgetpemsmith@gmail.com <br />Is your organization <br />physically located in <br />Orange County, NC? <br />Yes <br />Organization street <br />or PO Box address <br />200 North Greensboro St. Suite D-6 <br />DocuSign Envelope ID: 3B7987D4-AE68-4972-853F-8188A0E8440B