NWRDC/McKnight Small Capital
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 to 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 Small Capital Grant Instructions and eligibility.  


1. Applicant Organization (Legal Name, Address, Phone)



Phone
E-mail
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.)
4. Project Budget Summary
       $    Total Project Cost
       $    Total Match 
       $    Amount Requested 
(Remember that request plus match should equal cost.  Numbers should be the same as main budget pages.)   
5.  People benefiting from these purchases within one calendar year.
          Adults
   
     Children/Youth
6.  Storage or Permanent Location of Purchases
            

 

7. Describe the project for which NWRDC/McKnight Arts funds are being requested. (ie. sound system update for upcoming theater series) Include the goals of the project and details on how the project will be implemented.

8. Provide a brief history of your organization.

9. What plans for events/productions does your organization have for the coming year?

10. Other than grants received from the NWRDC, list the grants and/or other sources of community support you received the past two years that have made your organization successful.

11. How did you determine the need for this project?
How will this project meet the artistic needs of your community?

12. How will these funds enhance the quality of the art form/s provided by your organization?

13. How will you evaluate the success of this project?

14. What other sources have been sought for funding this project? What has been the response?

15. If you are applying for more than one item, prioritize your proposed expenditures for this project, with number 1 being the top priority.

16. Attach your organization’s annual operating budget for the current year.  This is required for this category. 

17. Attach any quotes/estimate for the project, and indicate the date and source of the quote/estimate. Attach any supporting material.


18. Project Budget

    a. List each item.
    b. Indicate "Not Applicable" if a line item does not pertain to your request.
    c. Attach additional pages as necessary

Capital Costs (Equipment)
Supplies and Materials (Expendable Items)
Other Costs 
TOTAL COST
FUNDING MATCH FROM OTHER RESOURCES
TOTAL PROJECT COST

19. The applicant organization must meet the following criteria to be eligible for NWRDC/McKnight Arts Grant funds. Please check the criteria that apply to your organization:
The organization is nonprofit tax-exempt under Section 501(c)(3) of the Internal Revenue Code.
The organization is arts producing with at least a six-month season.
The organization has been active for two or more consecutive years.

20. Check which of the following are enclosed:
Tax-Exempt Letter                                 Annual Budget (detailed) 
Cost Quotes (date and source indicated) Supporting Materials

21. 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
Project Director