Arts Project Grant (formerly Production Assistance/Sponsorship)
Final Report Form

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

FOR OFFICE USE ONLY    
Grant # _______________ Due Date _______________ Date Rcvd _______________
Award        _______________ Profit (Loss) _______________ Credit Line _______________
Audience        _______________ Artists _______________ Approved _______________
Comments:    

This form is due within 60 days of project completion.  The completed form must be printed and sent in the mail to our office with required signatures and a publicity sample that shows the required credit line.  On purpose, there is no SEND button.  We look forward to hearing more about the success of your project and we hope that you had a good experience working with the Northwest Minnesota Arts Council! 

1. Grant Recipient (Name, Address, City, Zip)


Phone
 Contact Name 		2.  Very Brief Project Description (Production Title or Sponsored Artist Name and Actual Dates of Activity)

Number of Performances
Days of Exhibition
3. Fiscal Agent (Agency Name, Address, Day Phone)
(Fill out Only if Applicable.)


Phone		 4.     Adult Artists Participating   
        Adult Audience                         
        Children/Youth Participating  
        Children/Youth Audience

5. List your project goals as described in your application and indicate how well those goals were met. Describe the project's impact on your organization, artists, and on the audience/participants served.

6. What methods did you use to evaluate your project? (Examples: Size of audience, participant questionnaires, personal observations of activities, follow-up meeting of project planners, etc.)

7. Did the project differ from the description in the grant application in any way? If so, please describe.

8. a. Describe the publicity and promotional efforts for this project.
    b. Submit evidence of use of the credit line described on the Arts Grant Contract.
    c. Attach any information such as schedule of activities, photos, clippings, programs, etc.

9. Name and describe the participation of other groups involved as co-sponsors or recipients of specific services.

10. Budget Summary
        A. Use figures from the total column of your application for "Estimated Budget".
        B. If in-kind is used, an "In-Kind Voucher" must be submitted documenting cash values.
        C. Actual in-kind can not be greater than 25% of the Total Project Cost.
        D. Actual in-kind can not exceed the amount originally budgeted.

ESTIMATED BUDGET

ACTUAL BUDGET
Cash    In-Kind Cash    In-Kind
Artist Fees or Contracts 
Salaries or Wages 
Supplies or Materials 
Transportation or Subsistence 
Publicity 
Rental 
Other 
TOTAL PROJECT COST
Earned Income
Cash
Other Grants
NWRDC Grant
In-Kind Contributions
TOTAL SUPPORT FOR PROJECT

Provide an explanation for any significant differences between budgeted and actual costs and income.

11. Provide any suggestions for improved NWRDC services.

12. Certification: We certify the information in this report 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