Public Art Project
Final Report Form

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

This form is due within 60 days of your stated project ending date.

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


Day Phone
 Project Director 		2. Brief Project Description (Name, Dates)
3. Fiscal Agent (Name, Address, City, Zip)


Day Phone 		4. Number of people artistically involved:

Adults
Youth

 

5. Describe the project's impact on your community and on the audience/participants served.

6. What methods did you use to evaluate your project?

7. Did the project differ from the description in the grant application in any way? If so, please describe.
FOR OFFICE USE ONLY    
Application # _______________ Due Date _______________ Date Rcvd _______________
Profit/Loss _______________ Credit Line _______________ Approval _______________
Comments:    

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.
          Make sure you send our office a good photo of the completed artwork.

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

10. Provide any suggestions for improved NWRDC services.

11. Budget Summary 

PRELIMINARY BUDGET ACTUAL BUDGET
(Page 3 of Final App.)
Artist Fees
Supplies or Materials
Transportation or Subsistence
Publicity
Rental
Other 
TOTAL PROJECT COST
Cash
Other Grants
NWRDC Grant 
TOTAL PROJECT INCOME

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

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