Directions: Please attach up to two typed pages answering questions 2 and 3. Please use 1 inch margins, size 12 font, and single spaced lines; include your name on the top of the page.  If you would like to be considered for the $4,000.00 grant that will be awarded to two individuals please include narrative and budget that relates to your proposed use for this higher level grant award. 

2. Project Description: Describe, in detail, the main project for which you are requesting assistance. If your project is a mentorship you must be learning a specific new technique. The purpose of the program is not to fund routine lessons. If you are planning to use the funds to pay other professionals, attend a training or workshop, or work with another artist please state the reputation and/or qualifications of the individuals/organization you will be working. State clearly that you have contacted them and they are in support of this project.

3. Goals/Evaluation/Sharing: Describe your career goals as an artist then relate them to the goals of this proposed project, include how you will decide at the end of this project (evaluation) whether these goals were achieved. Describe how and when you will show the results of your project to your home town and/or local community.

4. How many adults do you anticipate will benefit from your community activity?
Children/students?   (We are required to report this number to the state.)

5. Budget: List and describe the costs associated with this project. Attach additional pages as necessary. Items to include are training expenses, travel expenses, rental, supplies, equipment purchases, books, etc. Ineligible items are listed under #7 on the checklist (back of this page). Attach an extra page if necessary.
$
$
$
$
$
$
ESTIMATED TOTAL COST OF PROJECT (round to nearest $10): $

If your project will cost more than $1,500.00 please state where your matching funds will come from to show the feasibility of your projects completion:

Remember:  If you would like to be considered for the $4,000.00 grant that will be awarded to two individuals please include narrative and budget that relates to your proposed use for this higher level grant award. 

6. Certification: "My signature below certifies that I meet all of the eligibility requirements listed in the guidelines, that all information contained in this application and its attachments are true and correct to the best of my knowledge, and that I have submitted a complete application fulfilling all items on the checklist."

Applicant’s Signature:_________________________________ Date:______________________________

7. Application Checklist. Review each item and check the box provided when it has been completed. Items left blank will flag your application as potentially ineligible or incomplete.

    a. Application Required Attachments:
        Completed the application form.
        Application narrative answering questions 2 and 3 (no more than two pages)
        Work Sample and Work Sample Description
        Artistic Resume (no more than two pages)
        One letter of recommendation
    b. Eligibility Items:
        I am a northwest Minnesota resident for at least one year. 
        I am applying as an individual, not for any group or organization.
        I am at least 18 years of age.
        I do not have an outstanding final report due to the NW Arts Council.
        I have not, within the last three years, received a NW Arts Council grant. 
    c. My opportunity does not involve:
        Activities occurring outside of the stated time frame.
        Any organization at which I am employed.
    d. I will not use funds:
        For endowment funds.
        For excessive entry or exhibition fees.
        For tuition, school fees, or work toward a degree.
        For paying myself artist fees greater than $200.00.
        For activities primarily for the religious socialization of participants.
        For payment of debts incurred before the grant activities begin.
    e. Project Completion Items:
        I understand that my project cannot begin prior to January 1, 2011.
        I understand that my project must end by January 31, 2012 or earlier.
       If selected for a grant, I understand that I will need to complete and return the final report form for this project by March 1, 2012. This will include submitting receipts documenting my expenses.