Basic Contact Information

Name

Street Address

CityStateZipCode

Summary

Please succinctly describe/summarize your project and financial need:

Funding Required and Complete Proposal

What are you hoping to do? Project name/description:

Total dollar amount requested

Date(s) funds are needed or will be used:

Additional Dates (If Needed)

What exactly will this grant cover? (Tuition? Travel? etc.):

Why is this important to you?

Will anyone besides yourself benefit from this? Explain.

Please provide a hard copy or scan of the item or event for which you want funds, which includes the total cost. Please combine into one file for a single upload. (brochure / invoice – and/or – website screen shot / URL).

This is a need-based grant. Please describe why you believe you qualify for these funds on the basis of financial need. Include supporting documentation (like tax returns for you/parent), if possible. Please combine into one file for a single upload.


Special Skills or Qualifications

Summarize special skills and qualifications you have acquired from education, employment, previous volunteer work, or through other activities, including hobbies or sports which are relevant to this project. Also, please upload a resume using the upload tool below


Volunteer Experience

Applicants must have completed at least 4 hours of community service (non-musical performance) to a non-profit 501 c 3 arts or cultural organization for each $250 of aid requested (prior to receiving aid.) Please summarize your volunteer experience – what you did and how was it beneficial or meaningful. Also, include the name and contact information of whom you worked with (supervisor).

Organization Name

Organization Address

Supervisor

Organization Phone Number

Organization Email

Summary

Project Budget

List all expenses and source(s) of income)

Itemized Project Cost (describe & list $)

Itemized Project Cost (describe & list $)

Itemized Project Cost (describe & list $)

Total Project Cost

Amount of Grant Requested

Source and Amount of additional funding

Source and Amount of additional funding

Source and Amount of additional funding

Source and Amount of additional funding

Checklist

Letter of Interest emailedApplication completed and submittedVolunteer hours completed

Agreement and Signature

By typing my name and submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am awarded a grant, any false statements, omissions, or other misrepresentations made by me on this application will result in ineligibility.

Signature

Date