Arts Project Grant Application

Arts Project
Grant Application Form

Northwest Minnesota Arts Council - NWRDC - 115 South Main - Warren, MN 56762

FOR OFFICE USE ONLY	Date Rcvd _______________	Application # _______________
Type _______________	Discipline _______________	Award Date _______________
Rating ______________	Grant Award _______________

Hints for using this on-line application: First, hit refresh on your browser to make sure you are using the most current version. Second, do not allow the boxes to scroll since you will not be able to view that extra text when you print. Third, remember that you cannot save so plan ahead. Fourth, print off a copy and mail to our office with required original signatures and attachments. Make sure your pages are printing with a size 10 font in the boxes, otherwise adjust your print settings accordingly. Fifth, if you have a suggestion that would make this form function better email mara@nwrdc.org Full Arts Project Instructions and Guidelines.

1. Applicant Organization (Legal Name, Address)

Phone
E-mail
Web Site
2. Project Director (Name, Address, Day Phone)

Phone
E-mail

3. Date of IRS Tax-exempt Letter
Already on file at Arts Council
Enclosed as attachment
(First time applicants must include a copy of the letter.)
5. Total Annual Organizational Expenses   $

      (Last completed year)
4. Fiscal Agent (Agency Name, Address, Day Phone)
(Fill out Only if Applicable. A Contract Must Be Enclosed)

Phone

6. People benefiting from activity
         Adult Artists Participating
         Adult Audience
        Children/Youth Benefitting
        Hint: These numbers should be the same throughout application.
7. Project Budget Summary
       $      Total Expense
       $      Amount Requested
(Request cannot exceed 90% of the Total Expense. Numbers should be the same as main budget pages.)

8. Main activity dates

Entire Dates from Start to Finish: -
9.     Location of Activities

10. Certification: We certify the information in this application is true and correct to the best of our knowledge. Make sure two different people sign off for the project with original signatures.

Typed Name Title Signature Date

Authorizing Official

Fiscal Agent

Project Director

Proposed Project

11. Give a complete description of the project, including dates and times of activities.

12. Ticket and Admission Information
A. Number of performances or days of exhibition:
B. List the ticket price/s for this project:
C. List ticket price/s you have charged for similar events in the past two years:
D. How were ticket prices determined?

E. If you are not charging for this event, list the reasons why not:

F. What efforts have been made to seek financial support from the community for this project?

Merit and Artistic Quality

13. What are the specific goals of this project?

14. How will you evaluate the project?

15.   A. List the key artists, companies, professionals, and administrative personnel.
       B. Indicate why they were selected.
       C. Attach resumes for these people.

Need or Demand for the Project

16. How was the need for this project determined:
A. By artists?

B. By the community?

Ability of the Applicant to Carry Out the Project

17. Give a brief description of all arts-related projects undertaken by your organization in the past two years, including dates.

18. Describe the publicity and/or marketing efforts, including how the participants and public will learn of the project, a description of the methods (news releases, posters, brochures, etc.) that will be used, and the range of distribution of the publicity.

Needs Assessment Questions: this section is required and will help us to continue to assess the region's needs

19. In your community or county, what do you think is the greatest strength and what is most lacking in the arts?

20. What are your needs, other than funding, as an artist, arts organization or non-profit organization pertaining to the arts?

21. How could Northwest Minnesota Arts Council help you fulfill the needs identified in question 2?

Checklist

Check the following that apply to this application:
1. The organization carrying out this project is: (check the one that applies)
        a unit of government. (Includes cities, and departments or agencies of the state.)
         a non-profit, tax-exempt, 501(c)(3) organization,
                and a copy of the IRS Letter of Exemption is enclosed or is on file with the NWRDC.
        applying through a fiscal agent and the fiscal agent contract is enclosed.
2. Resumes/qualifications of key project personnel (artists, companies, director, etc.) are attached.

Proposed Budget
INSTRUCTIONS:

A. Maximum grant request of $3,000.00. D. See guidelines for questions related to

B. Show method of calculation eligibility of budget items.

(i.e., hours, rate, cost per item, etc.). E. Minimum 10% cash match required.

C. Round figures to nearest ten. F. Attach additional pages as necessary.

EXPENSE ITEM LIST
COVERED BY

COVERED BY
TOTAL

Explain in detail what items the money will be spent on: GRANT REQUEST OVERALL BUDGET

TOTAL EXPENSES

REVENUE BUDGET

Arts Project Grant Requested

(Same number as first column total above. $3,000 maximum)

Earned Income:

# People @ $

# People @ $

# People @ $

Cash:

Other Grants:

TOTAL CASH INCOME

(Remember a minimum 10% cash match required)

IN-KIND CONTRIBUTIONS ESTIMATE:

Please help us determine what donations of

personnel, artist fees, space, supplies, rent, etc.

regularly occur during the course of your proposal.

Include how your numbers were determined.

This helps us "make our case" for continued funding.

1. Applicant Organization (Legal Name, Address) Phone E-mail Web Site	2. Project Director (Name, Address, Day Phone) Phone E-mail
3. Date of IRS Tax-exempt Letter Already on file at Arts Council Enclosed as attachment (First time applicants must include a copy of the letter.) 5. Total Annual Organizational Expenses $ (Last completed year)	4. Fiscal Agent (Agency Name, Address, Day Phone) (Fill out Only if Applicable. A Contract Must Be Enclosed) Phone
6. People benefiting from activity Adult Artists Participating Adult Audience Children/Youth Benefitting Hint: These numbers should be the same throughout application.	7. Project Budget Summary $ Total Expense $ Amount Requested (Request cannot exceed 90% of the Total Expense. Numbers should be the same as main budget pages.)
8. Main activity dates Entire Dates from Start to Finish: -	9. Location of Activities

	Typed Name	Title	Signature	Date
Authorizing Official
Fiscal Agent
Project Director

A.	Maximum grant request of $3,000.00.	D.	See guidelines for questions related to
B.	Show method of calculation		eligibility of budget items.
	(i.e., hours, rate, cost per item, etc.).	E.	Minimum 10% cash match required.
C.	Round figures to nearest ten.	F.	Attach additional pages as necessary.

EXPENSE ITEM LIST	COVERED BY	COVERED BY	TOTAL
Explain in detail what items the money will be spent on:	GRANT REQUEST	OVERALL BUDGET










TOTAL EXPENSES
REVENUE BUDGET
Arts Project Grant Requested
(Same number as first column total above. $3,000 maximum)
Earned Income:
# People @ $
# People @ $
# People @ $
Cash:
Other Grants:
TOTAL CASH INCOME
(Remember a minimum 10% cash match required)


IN-KIND CONTRIBUTIONS ESTIMATE:
Please help us determine what donations of
personnel, artist fees, space, supplies, rent, etc.
regularly occur during the course of your proposal.
Include how your numbers were determined.
This helps us "make our case" for continued funding.