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Orange County Arts Commission Powered by Submittable <br />Name of organization <br />or business Five Head Entertainment <br />by Rachel Despard in NC CARES for the Arts <br />Grant Program <br />1289 Fordham Blvd, Suite 187, Chapel Hill, NC 27514 <br />N/A <br />Chapel Hill , North Carolina <br />27514 <br />United States <br />(704) 473-0739 <br />rachel@fiveheadentertainment.com <br />10/30/2020 <br />id. 18069461 <br />Original application 10/30/2020 <br />ORGANIZATION/BUSINESS <br />INFORMATION <br />n/a <br />Date organization <br />was formed <br />03/01/2011 <br />Authorizing Official James Rhine, Manager <br />Authorizing Official - <br />phone number <br />7044730739 <br />Authorizing Official - <br />email <br />jimmy@fiveheadentertainment.com <br />Grant Manager - <br />name (if different <br />from Authorizing <br />Official) <br />Rachel Despard <br />Grant Manager - <br />phone (if different <br />from Authorizing <br />Official) <br />9192258847 <br />Grant Manager - <br />email (if different <br />from Authorizing <br />Official) <br />rachel@fiveheadentertainment.com <br />Is your organization <br />physically located in <br />Orange County, NC? <br />Yes <br />Organization street <br />or PO Box address <br />1289 Fordham Blvd, Suite 187 <br />DocuSign Envelope ID: 324D941F-2C55-4E24-BAAA-FF3B9689CD67