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Artist in Residence Program 2012
Funding Application Form
GENERAL INFORMATION
Please read the Artist in Residence Program 2012 Funding Guidelines before you fill in this
application. Closing date for applications: 30 March 2012
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Arts Queensland has established a partnership with the Australia Council for the Arts and
Education Queensland, to provide an Artist in Residence Program (AIR) that recognises good
practice and encourages innovation in arts and education programs in Queensland.
The AIR Program gives artists an opportunity to broaden their experience and share their skills,
while providing school students, teachers and pre-service teachers with greater exposure to the
benefits of creative practice. It creates opportunities for artists, teachers and pre-service teachers
to work together on developing effective teaching methods and practices for the arts.
SECTION 1 APPLICANT* CONTACT INFORMATION
*The applicant is usually the person co-ordinating or leading the project – either the
artist or the teacher/Principal/Head of School. The applicant will be the signatory on
the funding agreement and be legally responsible for the grant monies if your
application is successful.
Applicant Name (in full)
School/Teacher Training
Institution
(where the project is occurring)
Street Address of applicant
Postal Address of applicant
(if different to street address)
Web site: www.
ABN (if applicable)
GST registered Yes ( ) No ( )
Legal status of organisation
(e.g. incorporated body)
Is organisation a ‘not for profit’ Yes ( ) No ( )
under its Articles of
Association or Constitution?
Contact Person
Title:
First Name:
Family Name:
Position / Role:
Mobile Phone:
Business Hours:
Fax:
Email:
@
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PROJECT INFORMATION (complete as applicable)
Project Title (please use this
project title on all correspondence
with Arts Queensland)
Name of School/Schools
Cluster/Institution
Name of Organisation
Name of Artist/s
Name of Professional
Association
Name of Project Coordinator
Name of Partner/s
Project funding amount $ (maximum $20 000)
requested
Project Start Date:
Project End Date:
*The residency must be for a minimum of 20 days or 100 hours.*
Artform area/s (please tick)
Visual Arts New Media Theatre Dance Video
Craft Design Writing Film Music
Other:
School and Community Profile: Tell us about your school or tertiary institution (no more than 100
words)
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SECTION 2 PROJECT DETAILS (3 pages maximum for this section)
The Project: What is it that you are proposing to create? Explain the artistic concept of the project.
Explain the need/demand for this project. How are you planning to do it? What do you envisage the
successful outcomes will be?
Artistic Integrity: Why was this artist(s) or arts organisation chosen? What experience does this
artist/arts organisation have working with young people or in the community? Include artist(s) CV as an
attachment to this application (including photo documentation of previous work).
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Student Centred Learning: How does this project align with the Queensland schools curriculum and
what are the links across the key learning areas? How does this project increase the capacity of students for
engagement, skills acquisition and experiential learning? How does this project support educational
outcomes?
Teacher Professional Learning: What skills/knowledge will be the focus for teacher learning? How and
when will the teacher learning occur? How does this project increase the engagement of teachers?
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Planning, Resources and Partnerships: (maximum 100 words for each criterion)
Please provide an outline of the project’s key dates and deliverables.
Please provide a list of key project personnel, coordinator / collaborators.
*Please attach a project plan co-signed by the artist and/or arts organisation and Principal/Head of School.
Target Students
Primary ( ) Secondary ( ) Special School ( ) Other ( )
Numbers of students involved in the project:
Numbers of teachers involved in the project:
Numbers of artists involved in the project:
Groups which will specifically benefit from the project (If applicable)
Aboriginal people Older people (over 55 years of age)
Torres Strait Islanders People with a disability
People from a culturally and linguistically Regional Queenslanders
diverse background Australian South Sea Islanders
Children (0–12 years of age) Women
Young people (13–30 years of age)
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SECTION 3 BUDGET
Applicants must complete the budget form on the next page of this Application Form to detail
expenditure items. If the form does not provide adequate space, use it as a summary and attach a
detailed budget and any explanatory notes. The budget should reflect the total costs of the
proposed project (maximum $20,000 AIR funding), and clearly specify the funds requested from
Arts Queensland. See Guidelines for additional details.
INCOME $ EXPENDITURE $ *
1
Earned Income Salaries, Fees, On-
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costs
2 6
Grants Project Costs
Artists and Others Marketing and
3 7
Contribution Promotion
AIR Funding
4 8
Other Administration
TOTAL INCOME TOTAL EXPENDITURE
*(must equal total expenditure) *(must equal total income)
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Budget Notes
If you are registered for GST, your expenditure and income should be exclusive of GST. If you are not
registered for GST, your expenditure should include the GST to be paid.
Expenditure to be funded through A.I.R. Program must be identified with an asterisk (*) in the column provided.
When you have completed your budget the Total Expenditure and Total Income must be equal.
1 If applicable, income earned from project 5 Salaries/fees
2 Education Queensland/Australia Council / Local Government / 6 Materials/Preparation/Equipment
State Government / Federal Government (C/NC)
3 Sponsorship/Donations/Fundraising 7 Promotions/Publicity (if applicable)
4 Cash/In-kind/Self investment/Value of materials 8 Office costs/Admin overhead
SECTION 4 SUPPORT MATERIALS
Please attach concise and relevant support materials. (Do not send original material as we are
unable to return it to you.) See Guidelines for details.
□ CV / Resumes □ Letters of confirmation / support □ Images
□ Media □ Project documentation □ CD / DVDs
□ Other (please describe)
SECTION 5 CHECKLIST
Before you submit your application, make sure you have:
read the guidelines and the relevant documents and website information provided;
completed all sections of the application;
provided any support materials;
signed the declaration;
project coordinator / collaborator signatures;
provided written confirmation of discussion and engagement with community collaborators;
retained a copy of the application for your own records.
Promotion
All successful AIR Program recipients are strongly encouraged to provide project information which
can be used by Arts Queensland, Education Queensland and the Australia Council as promotional
material e.g. good news stories or photographic materials. Program recipients must ensure they
have all the necessary consents and intellectual property rights in order to provide these without
infringement of any third party’s rights.
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Submitting your application
Please provide four (4) copies of your completed AIR funding application, including 4 copies of all
support material, either delivered to Arts Queensland or postmarked by the closing date.
Applications should be complete, with all relevant documentation included, and must be typed in
black ink on white A4 paper. Please do not staple or bind your application. Application pages must
be able to be easily separated. You can submit your application:
By post: Susan King, Arts Development Officer, Creative Communities, Arts
Development, Arts Queensland, GPO Box 1436 BRISBANE QLD 4001
For Information: Please contact: Susan King, Arts Development Officer, Creative Communities,
Arts Queensland p: 07 3224 5767 or susan.king@arts.qld.gov.au.
Assessment Process
Assessment and funding decisions are based on the information provided in your application,
including support materials. Applications will be assessed by a selection panel based on how well
they address the selection criteria on page 2 of these guidelines and the aims, objectives and
priorities of the 2012 AIR Program. Assessment decisions will be moderated to ensure balance
across phases of learning, art form areas and geographic locations. Results are expected to be
announced in June 2012 and applicants will be advised in writing of the outcome of their
application.
Information Privacy and Right to Information
The information you provide in your grant application may be used by Arts Queensland for the
following purposes:
processing and assessing your application – for this purpose, the information may be
provided to industry experts engaged by Arts Queensland
verifying other grant incomes for your project – for this purpose, the information may be
provided to other funding agencies nominated in your application
reviewing and evaluating Arts Queensland grant programs, strategies, plans and services –
we may contact you for this purpose
training
systems testing and process improvement
compiling statistics
If your application is successful, the information you provide in your grant application, the amount
of funding you receive, the information you provide in your progress reports and/or outcome
report/s and text and images relating to your funded activity may also be used by Arts Queensland,
including publication on its website, for the purposes listed above and for the following purposes:
processing, paying and administering your grant
reporting, including in the Arts Queensland annual report
promoting funding outcomes and Queensland’s arts and culture – for this purpose, the
information (including your contact details) may be provided to Queensland Government
Members of Parliament, the media and other agencies who may contact you directly
Arts Queensland treats all personal information in accordance with the Information Privacy Act
2009.
The provisions of the Right to Information Act 2009 apply to documents in the possession of Arts
Queensland.
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SECTION 6: DECLARATION
This declaration is to confirm that this project application is a collaborative application, the
result of consultation and discussion between all parties.
I have read the program guidelines, eligibility and selection criteria and certify that to the best of my
knowledge the information provided in this application is true and correct. I have provided a
completed application form, budget, written proposal and appropriate support material
Sign off from Applicant and any collaborator organisations.
APPLICANT
SIGNATURE:
NAME (Please print): DATE:
ORGANISATION:
PROJECT COORDINATOR
SIGNATURE:
NAME (Please print): DATE:
ORGANISATION:
COLLABORATOR
SIGNATURE:
NAME (Please print): DATE:
ORGANISATION:
COLLABORATOR
SIGNATURE:
NAME (Please print): DATE:
ORGANISATION:
COLLABORATOR
SIGNATURE:
NAME (Please print): DATE:
ORGANISATION:
COLLABORATOR
SIGNATURE:
NAME (Please print): DATE:
ORGANISATION:
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The information you provide in the following section will be used by Arts Queensland for
evaluation, reporting and administrative processes.
If you are an individual applying for a grant, do you identify with any of the
groups below?
An Aboriginal person A young person (13–30 years of age)
A Torres Strait Islander An older person (over 55 years of age)
An Australian South Sea Islander A person with a disability
A person from a culturally and A regional Queenslander
linguistically diverse background A woman
If you are an organisation applying for a grant, does your organisation identify
with any of the groups below?
An Aboriginal organisation A culturally and linguistically diverse
A Torres Strait Islander organisation background
An Australian South Sea Islander Regionally located
organisation
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