Arts Project Grant
| 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
| EXPENSE ITEM LIST | ESTIMATED |
ACTUAL CASH |
COMMENTS | ||
| Type the same headings as in your grant application: | BUDGET | BUDGET | |||
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| TOTAL EXPENSES | |||||
| REVENUE BUDGET |
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| Arts Project Grant Awarded | |||||
| 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. | |||||
| occurred during the course of your proposal. | |||||
| Include how your numbers were determined. | |||||
| This helps us "make our case" for continued funding. | |||||
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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 |