HUDSON COUNTY OFFICE OF CULTURAL & HERITAGE AFFAIRS by 2rZL2o

VIEWS: 6 PAGES: 54

									Hudson County Office of Cultural & Heritage Affairs/Tourism Development
           Fiscal Year 2011 Local Arts Program Grant (LAP)



                            Table of Contents


              Guidelines – pages 2-13

              State & Congressional Districts – page 14

              Application forms - pages 15-35

              Declaration Form – page 36

              Budget Forms – pages 37-42

              Certification – page 43

              Checklist – page 43

              ADA Organizational Plan – pages 44-46

              SAMPLE Budget Pages – pages 47-54

              Frequently Asked Questions – page 55




                                     1
HUDSON COUNTY OFFICE OF CULTURAL & HERITAGE AFFAIRS
                 /TOURISM DEVELOPMENT
         JUSTICE WILLIAM BRENNAN COURT HOUSE
                   583 NEWARK AVENUE
                   JERSEY CITY, NJ 07306
                        (201) 459-2070
                   www.hudsoncountynj.org

       FISCAL YEAR (FY) 2011 LOCAL ARTS PROGRAM GRANT (LAP)
FOR PROGRAMS AND SERVICES FROM JANUARY 1, 2011 TO DECEMBER 31, 2011

                              GUIDELINES
Funding for this program is made available through the New Jersey State Council
on the Arts/Department of State (NJSCA) and the Hudson County Board of
Chosen Freeholders. Applications are being accepted until Friday, September 24,
2010 for programs that will be offered between January 1, 2011 and December 31,
2011. In partnership with NJSCA, the Hudson County Office of Cultural &
Heritage Affairs (HCOCHA) offers matching grants to non profit organizations
located in, and serving the residents of, Hudson County. These grants are
administered through HCOCHA, a unit of Hudson County government, by
authority of the Hudson County Board of Chosen Freeholders.

                      DEADLINE FOR APPLICATION

Applications must be either hand-delivered to the Hudson County Office of
Cultural & Heritage Affairs (HCOCHA) by 5:00 p.m. on Friday, September
24, 2010 or postmarked by the U.S. Postal Service by this same date.
Applications with metered mail post marks will not be accepted. Applications that
are hand-delivered or postmarked after the deadline will not be accepted. Faxed
copies will not be accepted. There will be no exceptions.

ONLY THE ORIGINAL OFFICIAL APPLICATION FORM PROVIDED
MAY BE USED. (ORIGINAL APPLICATION FORMS ARE AVAILBLE IN
HARD COPY, ON WWW.VISITHUDSON.COM, AND FROM AN
OFFICIAL HCOCHA CD ROM.) Applicants are advised to read all the
directions thoroughly before beginning to fill out the application.



                                      2
                                    GOALS

Hudson County awards competitive matching grants to organizations, based on
merit and financial need that clearly demonstrate their commitment to the arts in
the County by producing or sponsoring arts programs and services of high artistic
quality and professionalism. Applicant organizations are expected to be
administered responsibly and to propose programs that can be completed within
the grant period and within the projected budget.

                        PRIORITIES FOR FUNDING

Special consideration will be given to proposals of quality, innovation, and merit
that address the following priority issues:
           Outreach programs to underserved communities (senior citizen,
              physically challenged, developmentally challenged, culturally
              diverse);
           Programs for municipalities in northern and western Hudson County;
           Promotes the growth of artists, arts organizations, and arts programs
              in Hudson County;
           Expands the influence of Hudson County artists.

                        APPLICATION WORKSHOP

HCOCHA will offer a workshop on how to complete this application on
Wednesday, September 8, 2010 from 6:00 to 8:00 p.m., in the Rotunda of Justice
William Brennan Court House, 583 Newark Ave, Jersey City. This is a barrier
free site. Sign Language interpretive services will be provided upon request, at
least one week before, to HCOCHA. NEW APPLICANTS, AND THOSE THAT
HAVE RECEIVED LESS THAN 50% OF THEIR PRIOR GRANT
REQUESTS, ARE STRONGLY URGED TO ATTEND.

                                 ELIGIBILITY

AN ORGANIZATION THAT MEETS THE FOLLOWING MAY APPLY:
       Is based in Hudson County
       Serves the residents of Hudson County
       Has been in existence for at least one full year as of 1/1/10
       Has been incorporated in the State of New Jersey and

                                       3
             is a tax exempt, non-profit organization, as approved and certified by
             the Internal Revenue Service (IRS) under section 501(c)3 or 501(c)4
            Unincorporated groups or those that have not received an IRS tax
             exempt status may apply for a Special Project or Mini Grant provided
             they can demonstrate organizational governance and financial
             oversight
            Exists primarily as an arts organization, or sponsors arts programs as
             a community outreach service – hospitals, libraries, schools,
             community organizations, and social service agencies are examples of
             sponsoring organizations. Sponsoring organizations are responsible
             for the writing and submission of the application, and will be
             accountable to HCOCHA for the management of the funded project
            Applies for funding to the County but not the State in the same fiscal
             year
            Is able to match the grant award as specified below under
             “Categories”

                 MULTIPLE APPLICATIONS ELIGIBILITY

NON ARTS ORGANIZATIONS, such as schools, hospitals, religious
institutions, social service agencies, or fraternal organizations, may apply in only
one of two program support categories: Special Project or Mini Grant.

ARTS ONLY ORGANIZATIONS may apply in two categories: a Program Grant
(GOS, MG, SP) and a Technical Assistance Grant. Note the restrictions where
applicable. Take notice of the restriction when applying for a Technical Assistance
grant and in another category.

Organizations with several divisions or agencies may only submit one proposal per
grant Fiscal Year.

SCHOOLS (AT ANY LEVEL – PUBLIC OR PRIVATE, OR ARTS
TRAINING OR ARTS IN EDUCATION PROGRAMS OR SCHOOLS) may
not request for or use LAP Grant funds for general operating support,
scholarships, tuition, school supplies, residencies, field trips, camps, humanities
lecture series, or any curricular or extracurricular activity that involves or
engages school programs, its students, and its teachers and their spouses,
relatives, children or friends. Schools are encouraged to contact the education
coordinator of the New Jersey State Council on the Arts for assistance in
identifying state grant programs or private foundations to support artist residencies.
                                         4
                               CATEGORIES

SPECIAL PROJECT (SP)

    Maximum Request:        $8,000
    Who may apply:          Non Arts and Arts Only organizations. Agencies
                            that sponsor arts programs as part of a broader
                            range of community outreach activities, such as
                            schools, social agencies, and libraries, may apply
                            in the Special project category.
    Eligible Uses of Funds: Programmatic costs, such as space rentals,
                            advertising, artist fees, props, etc., of presenting a
                            specific arts program, art exhibit, or series of
                            related arts programs. Examples of Special
                            Projects include: multi disciplinary performing
                            arts series, cultural tourism themed arts festivals,
                            concert series, art or photography exhibit, or
                            outreach services for the arts constituency.
                            Marketing materials that promote an event, series
                            of events, or arts organization, are also allowable
                            expenses.
    Requirements:           Applicants may apply for 50%, or half of the total
                            projected cost of their Special Project, up to a
                            maximum of $8,000. The applicant must provide
                            the other half of the total cost of the Special
                            Project. This is called a 1 to 1 match. Example:
                            Your special project expenses total $6,000; you
                            would request $3,000 and you would match it
                            with $3,000. Special Project applicants may
                            match the grant amount with cash, or, with the
                            total, in-kind dollar amount of those materials and
                            services (including space rent) that are crucial to
                            the presenting and planning of the special project.
    Restrictions:           An organization’s administrative costs cannot be
                            underwritten by this category. Organizations may
                            not reimburse themselves, through the LAP
                            Grant, for the administrative or operational
                            services it provides or donates to the Special
                            Project. Projects with budgets that are
                            incomplete or vague will receive low scores.

                                      5
                            MINI GRANT AND GOS APPLICANTS
                            MAY NOT APPLY FOR A SPECIAL
                            PROJECT GRANT IN THE SAME FISCAL
                            YEAR.
    Priority Consideration: (In addition to PRIORITIES FOR FUNDING)
                            HCOCHA encourages schools and non arts
                            organizations to use the Special Project grant as
                            an outreach service to collaborate with the local,
                            professional arts community to bring the work of
                            Hudson County and New Jersey artists and
                            performers to the general public.

TECHNICAL ASSISTANCE (TA)

    Maximum Request:        $5,000
    Who may apply:          Arts Only organizations that demonstrate a
                            genuine need for assistance in the areas of
                            organization, administration or artistic
                            development.
    Eligible Uses of Funds: One-time consultancies by qualified professionals
                            that will strengthen the professional
                            administration of arts organizations and the
                            quality of the programs they bring to the public.
    Requirements:           Organizations requesting artistic development
                            assistance must clearly demonstrate why this one-
                            time, professional consultancy is needed,
                            and how this new level of artistic quality will be
                            continued once the consultant leaves. Technical
                            Assistance grants do not require a match.
                            With this application you must submit a letter of
                            intent from the consultant, addressed to you,
                            explaining the following: 1) a clear statement of
                            what the consultancy will include; 2) a time-line
                            laying out dates when these services will begin
                            and end and how long each session will last; 3)
                            the professional qualifications of the consultant,
                            with references; 4) a final report and evaluation of
                            the consultancy, due upon its conclusion; 5) a
                            breakdown on the cost of this consultancy. All
                            expenses that are reimbursable to the consultant
                            through this grant must be backed up with actual

                                     6
                              receipts. Remember! Upon completion of the
                              technical assistance, HCOCHA requires an
                              evaluative report from the consultant regarding
                              the assistance provided to your organization.
    Restrictions:             Any Technical Assistance application that does
                              not include the consultant’s letter of intent will
                              be turned down automatically. Technical
                              Assistance proposals that request the services of
                              current and past employees, past and present
                              board members, relatives, friends or associates,
                              regardless of their professional consultancy
                              expertise, will not be considered.

GENERAL OPERATING SUPPORT (GOS)

    Maximum Request:        $15,000
    Who may apply:          Arts Only organizations. Applicants to this
                            category of support are of the highest artistic and
                            administrative professionalism, with a proven
                            multi county impact, that will be reviewed
                            accordingly.
    Eligible Uses of Funds: General operating and programmatic costs. Up to
                            15% of the grant may be used toward
                            administrative costs.
    Requirements:           Applicants must have at least one full-time paid
                            staff administrator; a proven fundraising
                            campaign; be fiscally responsible; and have an
                            active Board of Directors involved in the
                            governance of the organization. Applicants must
                            offer year round programs. The applicant must
                            submit a schedule of its Board of Director
                            meetings for FY 2009 & FY 2010, as well as a
                            letter from a recognized professional in the same
                            discipline attesting to the professionalism and
                            artistic quality of the organization. This letter may
                            not come from any individual connected with the
                            organization. All applicants who apply in this
                            category must compensate all artists involved in
                            their programs. The applicant must match the
                            grant request 1 to 1 and have at least 25% of that
                            match in cash. GOS applicants

                                     7
                             must submit a copy of the by-laws of the
                             organization with the application.
    Restrictions:            All applicants to the GOS category, including
                             previous GOS recipients, must first discuss this
                             option with HCOCHA before applying.
                             Applicants whose primary mission is arts
                             education may not apply under this category.
                             They are encouraged, however, to apply for an
                             Arts Basic to Education (A.B.E.) grant from the
                             New Jersey State Council on the Arts.
                             Organizations that rely upon membership dues or
                             fees for more than 25% of their operating budgets
                             are ineligible to apply in this category.

MINI GRANT (MG)

    Maximum Request:        $3,000
    Who may apply:          Non Arts organizations and Arts Only
                            organizations.
    Eligible Uses of Funds: To support the cost of a singular project
                            proposing to engage Hudson County artists for
                            public performance, art show, art project, folk art
                            or dance exhibition, craft making workshop,
                            literary publication.
    Requirements:           Applicant must match the grant funds 1 to 1.
    Restrictions:           Organizations may not reimburse themselves,
                            through the LAP Grant, for the administrative or
                            operational services it provides or donates to the
                            Mini Grant. GOS and SP applicants may not
                            apply for a Mini Grant in the same Fiscal
                            Year.
    Priority Consideration: (In addition to PRIORITIES FOR FUNDING)
                            Emerging organizations, organizations new to a
                            grants program, or those with limited human or
                            strategic resources are encouraged to apply in this
                            category.




                                    8
                  INELIGIBLE PROJECTS AND EXPENSES

Grants may not be used for:
         Administrative salaries, except for GOS applicants as previously
           defined
         Hospitality or food costs
         Capital improvements, such as renovation or construction
         Purchase of equipment, including fax, computers, etc.
         Projects that are for the curricular or extra curricular activities of a
           school
         Field trips to events or cultural programs
         Presenting performances, exhibits, and productions outside Hudson
           County
         Offsetting institutional/organizational budget deficits
         Collateral to obtain loans, to lend to other organizations, or in any way
           use for personal gain
         Programs whose sole emphasis is to motivate religious, sectarian,
           social welfare, or health education
         The acquisition of works of art, antiques, ephemera, etc.
         The restoration of statuary, historic property, etc.
         Parades, fashion shows, religious feasts or plays, food festivals,
           antique shows, etc.
         Fundraising activities or related fundraising costs
         Cash prizes, trophies, scholarships, tuition

                         ALLOWABLE ADA EXPENSE

Applicants are encouraged to budget appropriate expenses for ADA Program
accessibility, such as, but not limited to, sign language interpreters and large print
type programs. The purchase of equipment is not permitted. HCOCHA offers free
rentals of Assistive Listening Devices.

                        EVALUATION OF PROPOSALS

After all proposals have been reviewed by HCOCHA staff for eligibility and
guidelines compliance, they are then evaluated by an independent panel of peer
professionals in the arts. These panelists are chosen for their expertise in a
particular discipline and for their overall ability to critique the merits of proposals
in a fair and insightful manner. They review and score each proposal based upon a
criteria that includes the following:

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            The professional credibility of the applicant
            The merit and financial need of the project(s) proposed
            The artistic excellence of past and present projects
            The applicant serving the needs of its constituency by this proposal
            The applicant demonstrating community support
            The applicant presenting a true budget for all expenses
            The applicant providing clear, relevant answers to all questions
            Technical Assistance applicants demonstrating genuine need
            The applicant presenting an appropriate use for the requested funds
            The applicant addressing any of HCOCHA’s priorities for funding
            The applicant presenting a barrier free, content accessible program


A consensus critique is framed by the peer panel at its group meeting. HCOCHA
staff is present to facilitate the process in a timely and orderly manner and to
ensure fairness and objectivity. HCOCHA staff many not participate in the
discussion. The peer panel’s consensus critique is its collective impression and
professional evaluation of a proposal, based upon the information, answers to
questions, support materials, narrative, and overall application presentation
submitted by the applicant. The intent of the critique is to provide constructive
feedback on the merits of the proposal and the applicant’s organization.

                           APPLICATION POINTERS

      As with all other grant programs, HCOCHA LAP grants are awarded to
      support and acknowledge a meritorious proposal. They must not be
      perceived to be, nor are they intended to be, the sole source of funding to
      plan, create, or facilitate a project.

      Please read the guidelines carefully in their entirety.

      The HCOCHA LAP grant program is highly competitive. Successful
      applicants will have articulated the concerns of the EVALUATION OF
      PROPOSALS criteria throughout their application. Also keep in mind
      HCOCHA’s PRIORITIES FOR FUNDING.

      When calculating your budget, please remember to include all in-kind
      donations at their estimated dollar amount. These amounts are included in
      the matching funds acquired by your organization. Please remember to
      complete the in-kind budget chart in the application package.

                                         10
      Please consider your organization’s method of documenting its impact on
      geographical areas and underserved communities. Simple methods of such
      documentation are quick questionnaires and/or sign-in sheets that request the
      zip code of participants/audience members. (Please remember to be sensitive
      to the privacy of your patrons)

      Evaluation plays a critical role in the success of a project/organization.
      Please pay close attention to the efforts your organization has made to
      evaluate its programs/services. Evaluation and geographical impact data may
      be obtained together using an array of techniques. Please consider
      questionnaires, comment sheets, and statistical information when
      determining your evaluation plan.


                          GRIEVANCE PROCEDURE

Applicants may not appeal their grant award on the basis of disagreement with the
consensus critique of their proposal. Applicants may not appeal their grant award if
any part of their proposal contains ineligible expenses or requests that are not
allowable under the guidelines. Applicants may not appeal their grant award based
on outdated HCOCHA guidelines. New or additional information that was omitted
from the submitted application may not be used as grounds for grievance.

Applicants who can demonstrate a pattern of gross misunderstanding on the part of
the grant panel, as written in the panel’s consensus critique, based on the facts on
file with HCOCHA, information or support materials contained in their submitted
application, may appeal their grant award. Applicants who can factually document
that the consensus critique of their proposal contains actual statements of bias
against race, age, religion, physical or developmental aptitude, cultural diversity, or
sexual orientation may appeal.


Applicants who meet the grievance procedure requirements may submit a written
appeal up to thirty days past the date on the HCOCHA letter of recommended
grant award and proposal critique. Appeals will not be considered after this time
period. Appeals by telephone will not be answered. Appeals that meet the
grievance procedure requirements will be reviewed by HCOCHA and the Hudson
County Board of Chosen Freeholders. Applicants will receive a written response
from HCOCHA with appropriate action, if any, no later than thirty days past the
appeals due date.



                                         11
                              SITE EVALUATORS

Arts administrators and artistic professionals are engaged by HCOCHA to make
site visits to funded programs and services during the fiscal year. They are asked to
complete an HCOCHA site evaluator’s report, which includes fulfillment of the
funded project, ADA compliance, audience response, and an assessment of the
quality of the project.

                                ACCESSIBILITY

The Americans with Disabilities Act (ADA), signed into Federal law in 1990,
requires that all public programs and services be made accessible to all people,
regardless of an individual’s physical or developmental challenges.
The State/County Partnership LAP Program Grant supports and enforces this law.
HCOCHA requires that:
              All applicants develop an ADA Organizational Plan.
                                  (See Section 8)

               ACCESSIBILITY COMPLIANCE PROCEDURE

Applicants who do not submit a detailed ADA Organizational Plan will not be
considered for funding. Applicants, funded through the block grant program, who
give false or misleading statements may forfeit their entire grant award and will be
excluded from future participation in the block grant program.

                ACCESSIBILITY GRIEVANCE PROCEDURE

Artists or members of the public who are unable to participate in a HCOCHA
State/County funded project because of a physical or program content barrier may
submit a grievance. In such a case, HCOCHA staff will investigate each complaint.
The recommendations are then presented to the Hudson County Counsel for legal
review.


                       ANNOUNCEMENT OF AWARDS

County grant awards are announced by letter. If awarded a grant you will receive a
first payment of 75% of your total award in the late first quarter of the new fiscal
year.




                                        12
                       PAYMENT & FINAL REPORTS

Grant funds are disbursed, after receiving properly completed and signed contracts
and payment vouchers, as follows: 75% after receipt of the County contracts and
vouchers; 25% after receipt of the final report and final payment vouchers.


  A COMPLETED FINAL REPORT MUST BE SUBMITTED BY
             FRIDAY, DECEMBER 2, 2011


1. Grant recipients must adhere to the proposal approved in the original
   application. If any changes are to be made to the proposal, recipients must
   notify HCOCHA in writing, in advance of the program start date, for approval.

2. Grant recipients must keep records of the number of people who are served by
   their programs, including the number of underserved residents (i.e., culturally
   diverse communities, persons with physical or developmental challenges, senior
   citizens), and the number of artists served or participating in the program(s).

3. Grant recipients must keep all receipts as they will be required for submission
   with the final report.

4. Organizations that are funded directly by NJSCA for General Operating
   Support are not eligible for General Operating Support from this grant
   program.

5. Applicants must provide all the materials pertaining to their category as
   requested in the guidelines and in the checklist section of the application.




                                       13
        Listing of Hudson County Congressional & State Legislative Districts

                              Congressional Districts*

9th:           Bayonne, Jersey City, Kearny, North Bergen, Secaucus

10th:          Bayonne, Jersey City

13th:          East Newark, Guttenberg, Harrison, Hoboken, Jersey City, Kearny,
               North Bergen, Union City, Weehawken, West New York


   * Bayonne, Jersey City, Kearny, North Bergen residents: See below if you are
                             unsure of your District

                             State Legislative Districts*

31st:          Bayonne, Jersey City

32nd:          East Newark, Harrison, Jersey City, Kearny, North Bergen, Secaucus

33rd:          Guttenberg, Hoboken, Jersey City, Union City, Weehawken,
               West New York


*Jersey City residents: See below if you are unsure of your District


*If you are unsure of either your Congressional or State Legislative District call the
Hudson County Clerk’s Office at (201)369-3470 during business hours,
                    or go online to www.hudsonncountynj.org




                                         14
      HUDSON COUNTY OFFICE OF CULTURAL AND HERITAGE
          AFFAIRS/TOURISM DEVELOPMENT (HCOCHA)
              LOCAL ARTS POGRAM (LAP) GRANT
       FOR PROGRAMS AND SERVICES FISCAL YEAR (FY) 2011
             JANUARY 1, 2011 TO DECEMBER 31, 2011

                   Only These Official Forms May Be Used
                            Follow All Directions
                 Incomplete Applications will not be accepted

 HAND WRITTEN APPLICATIONS WILL RECEIVE LOWEST SCORES

Congressional District #:                 NJ Legislative District #:

Federal I.D.# (If applicable):

Circle Grant Category Request(s): GOS         MG        SP      TA

Incorporated Name of Organization Applying for this Grant:


Organization’s Current Mailing Address:



Telephone:                                 Fax:

Email:

Web Site:

Name of Applicant’s Contact Individual:

Contact Telephone:                         Fax:

Email: (If different from above)

Site(s) of Proposed Project(s):

Date(s) of Proposed Project(s), Must be completed with dates, even if they are
approximate:

                                     15
ORGANIZATION NAME:


Is Your Organization Receiving Funding from another New Jersey county’s
Arts Agency? Circle one answer.

No                 Yes (List the name of the county arts organization(s))


Arts Only Groups – Circle the artistic disciplines that apply to your
organization’s mission statement:

Vocal Music Media Arts Literature Instrumental Music Crafts
Visual Arts Multi Disciplinary  Dance Theater Museum
Other (Explain)


Non Arts Groups – Circle all that apply to your organization’s mission
statement:

Health Services     Educational             Government
Social Services
Other (Explain)




                                      16
                   THE PROJECT PROPOSAL
   PROPOSAL NARRATIVES THAT FULLY ANSWER ALL PARTS HAVE A
       BETTER CHANCE FOR A SUCCESSFUL GRANT AWARD


      SPECIAL PROJECT (SP) & MINI GRANT (MG) NARRATIVE


Describe the project for which you are requesting funds (250 words or less)




                                     17
How does this project relate to your organization’s mission statement?




What process was employed to plan your project, including selection of artists or
performers, music, plays, etc.? Who makes all decisions?




                                       18
 Is this a collaborative project? If yes, describe the other organization(s), how
this collaboration came about, and the role each organization plays in this
project.




What are the goals that you hope to achieve for your constituency or audience
and for your organization from sponsoring or presenting this project?




                                        19
Does this project support HCOCHA’s “Priorities for Funding”, as stated in the
guidelines?




What items in your project budget will the LAP Grant funds be used to support?




 Is this the ONLY grant program your organization is applying to for its project?
If no, please list other grants you’re applying to.




                                       20
Who are the key personnel who will carry out this project? How are they
qualified to carry out this project?




Name the community outreach organizations that you will be utilizing to build
an audience for your project.




                                      21
Explain in detail your marketing plan for this project, including media outlets
you use to publicize your program.




How will your program be marketed to physically and developmentally
challenged individuals and the organizations that serve them, as well as those
individuals and communities listed under “Priorities for Funding” in the
guidelines?




                                       22
SPECIAL PROJECT & MINI GRANT REQUIRED SUPPORT MATERIALS
  Formal Mission Statement
  Resume(s) of key personnel involved in this project. Non Arts
   Organizations: attach the resume(s) of any outside facilitator(s) who
   will be engaged specifically to run this project
  Collaborative Projects: If this is a collaboration with another
   organization(s), either arts or non arts, attach organizational
   background material on each organization involved
  ADA Organizational Plan
  Promotional materials, critical reviews, newspaper articles, or samples
   to substantiate organizational merit and quality programming
  Audio; DVD; CD; slides; photographs; or CD-ROM support materials
   for the appropriate performance art or visual art proposal
  Checklist
                                      ∆




                                   23
       GENERAL OPERATING SUPPORT (GOS) NARRATIVE ONLY


Give a brief history of your organization.




                                        24
Cite major accomplishments within your current long range plan.




How do you evaluate the quality of your organization’s programs and services to
achieve the goals of your current five year plan?




                                      25
GOS applicants must demonstrate that they are drawing a multi county
audience. Give specific, detailed audience demographics; how were they
gathered?




How does the continued growth of your organization make an impact on the
cultural life of this county and that of the immediate multi county region of New
Jersey? What specific examples of programs or services have filled a void in the
communities you serve?




                                       26
Does your organization’s mission statement support HCOCHA’s “Priorities for
Funding,” as stated on page two of the guidelines?




Give an overview of the financial well being of your organization. Why are you
seeking financial support from this grant program? Indicate any other sources
of financial support you are seeking, including such initiatives as program
specific support and capital projects, as well as general operating support.
Describe projected fundraising goals and earned income activity.




                                      27
Describe the governance of your organization. Who makes fiscal decisions,
personnel decisions? How are programs & services developed?




Does your constituency or audience have any input in the development of your
programs? If so, how?




                                     28
Does your organization collaborate with other organizations, arts or non arts, to
develop or present projects? If so, how do you choose these organizations?




Explain the method of community outreach for your programs and
your marketing plan, including media outlets you use to publicize your
programs.




                                       29
How will your program be marketed to physically and developmentally
challenged individuals and the organizations that serve them, as well as those
individuals and communities listed under “Priorities for Funding” in the
guidelines?




                      GOS REQUIRED SUPPORT MATERIALS
      Formal Mission Statement
      By laws
      Organizational Budget
      Board of Directors list
      Board of Directors meeting schedule for ‘09 & ‘10
      Copy of State Of New Jersey Non profit incorporation
      Current Long Range Plan, stating progress made to date
      Most recent financial audit
      Resumes of key personnel and Board of Directors
      ADA Organizational Plan
      Promotional materials, critical reviews, newspaper articles, or samples to
       substantiate organizational merit and quality programming
      Audio; DVD; CD; slides; photographs; or CD-ROM support materials
      Checklist
                                        ∆

                                       30
            TECHNICAL ASSISTANCE (TA) NARRATIVE ONLY
                 ALL PARTS MUST BE ANSWERED.

Describe in detail what kind of organizational Technical Assistance is needed
and why? You must cite specific problems or situations to justify your request for
assistance and why a consultant should be brought in.




                                       31
How did you locate this consultant? Is the consultant a former employee or
board member? Is the consultant a relative, friend, or associate of an employee
or board member? Indicate your organization’s key personnel who will work
with the consultant.




How will you monitor the long term results of this consultancy?




                                       32
Why are you requesting financial support from this grant? Are there any other
funding sources being sought for this technical assistance?




       TECHNICAL ASSISTANCE REQUIRED SUPPORT MATERIALS
      Consultant’s Letter of Intent
      Resume(s) of Consultant(s);
      Resume(S) of Key Organizational Personnel who will work with the
       consultant
      Formal Mission Statement (If you are applying in more than one
       funding category only 1 copy is required)
      ADA Organizational Plan
      Promotional materials, critical reviews, newspaper articles, or samples
       to substantiate organizational merit and quality programming (if
       applying in more than one category only 1 copy necessary)
      Audio; DVD; CD; slides; photographs; or CD-ROM support materials
      Checklist




                                      33
LAP FY2011 ORGANIZATION NAME:


GOS only – FY 2011 planned fundraising activities: What is your
organizational goal total to be raised? Describe each activity and give projected
amount to be raised for each. What role does your Board of Directors play in
each activity?




                                       34
                         FY 2011 BUDGET FORMS

   PROGRAMS & SERVICES JANUARY 1, 2011 - DECEMBER 31, 2011

       BEFORE BEGINNING THE BUDGET PAGES, REMEMBER:

A. THE GRANT REQUEST LIMITS ARE:
     Special Project (SP)             $8,000
     Technical Assistance (TA)        $5,000*
     General Operating Support (GOS) $15,000
     Mini Grant (MG)                  $3,000

*Available to ARTS ONLY ORGANIZATIONS who may apply solely in this
category or in addition to one other category, Special Project, Mini Grant, or
General Operating Support

B. MATCH REQUIREMENTS:
    SP, GOS, MG GRANTS MUST BE MATCHED DOLLAR FOR
DOLLAR (1 TO 1). THE MATCH MAY BE PART CASH AND PART IN-
KIND GOODS AND SERVICES;

      COLLEGES AND UNIVERSITIES MUST MATCH AT 2 TO 1;

      TA GRANTS DO NOT REQUIRE A MATCH;

    GOS ORGANIZATIONS MUST PROVIDE 25% OF THE MATCH IN
CASH. IN-KIND GOODS AND SERVICES MAY BE USED FOR THE
REST OF THE MATCH. 15% OF THE GRANT REQUEST MAY BE
USED FOR ADMINISTRATIVE SALARIES.

C. IN-KIND INCOME
     IN-KIND INCOME MUST ALSO APPEAR IN THE APPROPRIATE
EXPENSE LINE ITEM. FOR EXAMPLE, THE DONATION OF SPACE
RENT AT $1,000. WOULD BE INCLUDED AS A DOLLAR AMOUNT
EXPENSE UNDER “FACILITIES” IN THE “IN-KIND” COLUMN

D.  COMPLETE THE APPLICATION FORM IN ITS ENTIRETY
ANSWERING ALL PARTS AND SUBMITTING ALL REQUIRED
SUPPORT MATERIALS



                                      35
ORGANIZATION NAME:

                            FY 2011 LAP PROGRAM GRANT
                            FOR PROGRAMS AND SERVICE
                     JANUARY 1, 2011 TO DECEMBER 31, 2011
                   GRANT(S) PROPOSAL REQUESTED AMOUNT
                   TOTAL EXPENSES/BUDGET DECLARATION
                    Fill in Only What is Applicable to Your Proposal

GOS Grant Proposal Amount Requested          ________________


MG Grant Proposal Amount Requested           ________________



SP Grant Proposal Amount Requested           ________________



TA Grant Proposal Amount Requested           ________________



TOTAL AMOUNT REQUESTED                       ________________




TOTAL PROJECT EXPENSES BUDGET FOR MG, SP, or TA

                                             ________________


TOTAL ANNUAL OPERATING BUDGET (GOS ONLY)

                                             ________________




                                        36
ORGANIZATION NAME:

                             FY 2011 PROJECTED BUDGET - JANUARY 1, 2011 TO DECEMBER 31, 2011
                                     SPECIAL PROJECT & MINI GRANT PROJECT EXPENSES


Expense                                                                                        Amount
1. Personnel
A. Project Administration
B. Other (list)
C. Bookkeeping
D. Travel/Transportation
E. Fringe (If applicable)
2. Administrative Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage/Mailing
D. Miscellaneous (list)
3. Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other
4. Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other (list)
5. Artistic
A. Personnel (including designers, musicians, crew, actors, dancers, etc.)
B. Sets, Lighting, Costumes, Musical Instruments
C. Royalties
D. Travel/Transportation
E. Fringe
F. Insurance
G. Other (list)
6. Program and/or Site Accessibility (List, e.g. sign language, Braille print, etc.)
7. GRAND TOTAL PROJECTED EXPENSES




                                                                     37
ORGANIZATION NAME:
                            FY 2011 PROJECTED INCOME –JANUARY 1, 2011 TO DECEMBER 31, 2011
                                        SPECIALPROJECT (SP) & MINI GRANT (MG)

Source                                                                                                                  Amount
PROJETED EARNED INCOME
A. Admissions
B. Subscriptions
C. Sponsorships/Other Cash Contributions
D. Fundraising/Special Events
E. Other Grants (DO NOT INCLUDE YOUR LAP REQUEST)
TOTAL PROJECTED EARNED INCOME

PROJECTED IN-KIND INCOME
Personnel
A. Project Administration
B. Other (list)
C. Bookkeeping
D. Travel/Transportation
E. Fringe
Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage/Mailing
D. Miscellaneous
Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other
Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other
Artistic
A. Personnel (including designers, musicians, crew, actors, dancers, etc.)
B. Sets, Lighting, Costumes, musical instruments, etc.
C. Royalties
D. Travel/transportation
E. Fringe
F. Insurance
G. Other (list)
Program and/or Site Accessibility (list)
TOTAL PROJECTED IN-KIND INCOME

                                                                        A. FY 2011 MATCH
                                                                        (Total Earned Income + In-Kind Total Income)    __________

                                                                                                                       +
                                                                        B. FY 2011 LAP GRANT REQUEST                    __________
                                                                        TOTAL INCOME (add A+ B)                         __________

                                                                   38 GRAND TOTAL PROJECTED EXPENSES                    __________
ORGANIZATION NAME:

                       FY 2011 PROJECTED BUDGET - JANUARY 1, 2011 TO DECEMBER 31, 2011
                                 GENERAL OPERATING SUPPORT (GOS) EXPENSES


Expense                                                                                  Amount
1. Personnel
A. Administration (list titles & salaries)
(for hourly wages give amount and titles)


B. Artistic (list titles & salaries, including designers, crew, etc.)
(for hourly wages give amount and titles)

C. Support staff
D. Travel/Transportation
E. Fringe Administrative & Artistic
2. Administrative Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage
D. Miscellaneous

3. Production/ Exhibition
A. Sets/Costumes/Lighting/Musical Instruments

B. Royalties
C. Travel/Transportation
D. Insurance
4. Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other (list)
5. Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other (list)
6. Program and/or Site Accessibility
(List, e.g. sign language, Braille print, etc.)
7. GRAND TOTAL PROJECTED GENERAL OPERATING EXPENSES 2011




                                                                 39
ORGANIZATION NAME:

                    FY 2011 PROJECTED INCOME - JANUARY 1, 2011 TO DECEMBER 31, 2011
                               GENERAL OPERATING SUPPORT (GOS) GRANT

Source                                                                                               Amount
 Projected Earned Income
 A. Admissions
 B. Subscriptions
 C. Sponsorships/Other Cash Contributions
 D. Fundraising/Special Events
 E. Other Grants (DO NOT INCLUDE YOUR LAP REQUEST)
 TOTAL PROJECTED EARNED INCOME

Projected In-Kind Income
Personnel
A. Administration
B. Artistic
C. Support staff
D. Travel/Transportation
E. Fringe
Administrative Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage
Production
A. Sets/Costumes/Lighting/Musical Instruments
B. Royalties
C. Travel/Transportation
D. Insurance
Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other
Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other
Program and/or Site Accessibility
TOTAL PROJECTED IN-KIND INCOME

                                                      A. FY 2011 MATCH
                                                      (Total Earned Income + In-Kind Total Income)    __________

                                                                                                     +
                                                      B. FY 2011 LAP GRANT REQUEST                    __________

                                                      TOTAL INCOME (add A+ B)                         __________

                                                   40 GRAND TOTAL PROJECTED EXPENSES                 __________
ORGANIZATION NAME:

                 FY 2011 PROJECTED BUDGET - JANUARY 1, 2011 TO DECEMBER 31, 2011
                                TECHNICAL ASSISTANCE (TA) EXPENSES


Expense                                                                            Amount
1. Consulting Personnel
A. Administrative
B. Artistic
C. Support Staff
D. Travel/Transportation/Accommodations
E. Fringe
2. Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage/Mailing
D. Miscellaneous (list)

3. Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other (list)
4. Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other (list)
GRAND TOTAL PROJECTED TA EXPENSES
YOUR FY 2011 TECHNICAL ASSISTANCE LAP REQUEST




                                                   41
ORGANIZATION NAME:


                           CERTIFICATION

I HEREBY MAKE THE FOLLOWING STATEMENTS ON BEHALF OF THE
ORGANIZATION LISTED IN THIS APPLICATION.

I CERTIFY THAT THIS APPLICATION IS COMPLETE AND IN ACCORDANCE
WITH THE CHECK LIST. THE INFORMATION IN THE APPLICATION IS TRUE
AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I HEREBY RELEASE THE
HUDSON COUNTY OFFICE OF CULTURAL & HERITAGE AFFAIRS, ITS
EMPLOYEES AND AGENTS FROM ANY LIABILITY AND/OR RESPONSIBILITY
CONCERNING THIS APPLICATION AND THE PROGRAMS SET FORTH. I
FURTHER CERTIFY THAT FUNDS AWARDED BY THE HUDSON CCOUNTY
STATE/COUNTY LOCAL ARTS PROGRAM GRANT WILL BE USED EXCLUSIVELY
FOR THE PURPOSE SET FORTH IN THIS APPLICATION, AND I WILL NOTIFY, IN
WRITING, THE HUDSON COUNTY OFFICE OF CULTURAL & HERITAGE
AFFAIRS IMMEDIATELY OF ANY CHANGE IN THE INFORMATION SUBMITTED
IN THIS PROPOSAL. I WILL COMPLY WITH TITLE VI OF THE CIVIL RIGHTS
ACT OF 1964 (PL 88-352), WITH LABOR STANDARDS UNDER SECTION (5) (1) OF
THE NATIONAL FOUNDATION ON THE ARTS & HUMANITIES ACT OF 1965 (PL
185-209), WITH TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, SECTION
504 OF THE REHABILITATION ACT OF 1973, WHICH RECEIVE FEDERAL
FINANCIAL ASSISTANCE, AND WITH THE AMERICANS WITH DISABILITIES
ACT OF 1990. TITLE VI, SECTION 504, AND TITLE IX PROHIBITING
DISCRIMINATION ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN,
HANDICAP OR SEX IN ANY PROGRAM OR ACTIVITY RECEIVING FUNDS FROM
A FEDERAL ASSISTANCE PROGRAM. THE NJSCA STATE/COUNTY
PARTNERSHIP BLOCK GRANT PROGRAM RECEIVES PART OF ITS FUNDING
THROUGH THE NATIONAL ENDOWMENT FOR THE ARTS (N.E.A.), A FEDERAL
ASSISTANCE PROGRAM.

NAME OF ORGANIZATION:



SIGNATURE OF CHIEF OFFICER, TITLE                               DATE
(DIRECTOR OF PROJECT, CEO, PRODUCER, MAY SIGN ABOVE)



SIGNATURE OF BOARD PRESIDENT, TITLE                       DATE
(CHAIRMAN OF THE BOARD OR BOARD SECRETARY MAY SIGN ABOVE)




                                       42
ORGANIZATION NAME:


                                           FY 2011 Checklist
        CHECK OFF ALL ITEMS THAT YOU HAVE SUBMITTED WITH YOUR PROPOSAL(S).
          ATTACH THIS SIGNED LIST TO THE FRONT PAGE OF YOUR APPLICATION.
                     HAVE YOU INCLUDED THE FOLLOWING ITEMS?
       ALL REQUIRED PAPERWORK MUST BE ATTACHED TO EACH APPLICATION

      ALL APPLICANTS: 1 original application with original signatures in blue ink; plus 6 copies
      of the application;

         1. ALL APPLICANTS: 7 full sets (of supporting materials: news clippings,
            brochures, press releases, flyers, etc. DANCE, THEATRE, OPERA MUST
            SUBMIT 1 MUSIC CD ; ART EXHIBITS 7 SLIDES OF THE PROPOSED
            ARTIST’S OR ARTISTS’ WORK;

         2. GOS: 7 copies of your IRS 501(c)3 or 501(c)4 designation or pending status letter
            from the IRS and 7 copies of your New Jersey Incorporation papers;

         3. GOS: 7 copies of your most recent audit;

         4. GOS: 7 copies of your most recent fiscal year organization budget;

         5. GOS: 7 copies of a list of your Board of Directors, with titles, cultural
                 diversity, and work affiliations of each member;

         6. ALL APPLICANTS: 7 copies of the resume of the executive director or
                 project director of your organization;

         7. GOS, MG, SP: 7 copies of the resumes of the artists and administrators
                 involved in your project or organization;

         8. TA: 7 copies of the consultant’s letter of intent and resume;

         9. GOS: 1 copy of by laws; 1 copy of the Board of Directors FY 09 & 10 meeting
            schedule;

         10. 7 copies of your ADA organizational plan

         11. GOS: 7 copies of your 5 year organizational plan;




      SIGNATURE OF PERSON RESPONSIBLE FOR ALL CONTENTS                        DATE




                                                 43
                 HUDSON COUNTY OFFICE OF CULTURAL & HERITAGE
                     AFFAIRS/TOURISM DEVELOPENT (HCOCHA)

                            ADA ORGANIZATIONAL PLAN
                       AMERICANS WITH DISABILITIES ACT (ADA)

A universal or inclusive environment for the arts is one that is usable by everyone, people with and
without disabilities and people of all ages. It is an environment with buildings, grounds, and
communication systems that are usable by everyone. It is an environment where programs and
exhibits are chosen that reflect a commitment to being part of an inclusive community. The
Americans with Disabilities Act (ADA) signed into Federal law in 1990 requires that all public
programs and services be made accessible to all people, regardless of an individual’s physical or
developmental challenges. The State/County Local Arts Program Grant Program supports this law.
To ensure that the arts are accessible to all, the New Jersey State Council on the Arts (NJSCA)
requires that all re-grantee groups submit an ADA Organizational Plan, adopted by formal resolution
of the re-grantee’s Board of Directors with their Local Arts Programming Grant (LAP) Applications
for 2011.
The Plan will become part of the re-grantee’s file and will not have to be re-submitted each
year. However, each year thereafter that any re-grantee applies to the LAP program, a report
of progress implementing the ADA Organizational Plan is mandatory.

                       ACCESSIBILITY COMPLIANCE PROCEDURE

Applicants who do not submit an ADA Organizational Plan, as outlined in the following paragraphs,
will not be considered for funding. Applicants, funded through the grant program, who give false or
misleading statements, may forfeit their entire grant award and may be excluded from future
participation in the LAP grant program. All applicants must attach an ADA Organizational Plan with
their 2011 LAP Application.

                                        SCOPE OF PLAN

Plans submitted with LAP 2011 applications will span a three year period and must address issues of
policy, programs, facilities, and audience/ artistic outreach. Groups that do not own their own
spaces/facilities are still required to comply with ADA accessibility issues in their programming and
facilities.

Plans must show areas of compliance, goals and objectives, and dates for accomplishing goals.

Your ADA Organizational Plan requires careful thought and analysis of your facilities, your
programming, and plans for outreach. Plans will vary in length depending on the mission, size and
scope of your organization. An ADA Organizational Plan should describe your accomplishments and
outline any future goals and objectives for making your facilities, programs, and services accessible
to persons with disabilities.

                                               44
ADA Organizational Plans should be submitted in a combined narrative and graph form. A sample
graph follows that can be used and copied if more pages are necessary. The narrative page or pages
should be attached to the graph. The name of the organization should be at the top of each page of
the Plan. If your organizational plan is already on file with HCOCHA, submitted with a previous
fiscal year LAP application, indicate the progress to date in facilitating it.


                                   AREAS INCLUDED IN PLAN

Areas that must be addressed in all ADA Organizational Plans submitted with the LAP 2011 Grant
Application must include: Board of Directors Resolutions regarding ADA policy; appointment of an
ADA Compliance Officer; a grievance policy; facility analysis and plans for compliance; outreach
both for audience and artistic engagement; publications; and neighborhood accessibility. You must
also show attendance at one or more workshops given by either Hudson County Office of Cultural &
Heritage Affairs/Tourism Development (HCOCHA) regarding ADA, or another organization
regarding ADA compliance, issues.


                            HELPFUL WEBSITES AND RESOURCES

A self-assessment survey tool has been developed by the NJ Arts Access Task Force and is available
on the NJSCA website: www.njartscouncil.org or by calling the NJSCA at 609-292-6130. An ADA
Organizational Plan outline is available online at www.njtheatrealliance.org: go to their Access Task
Force page and see: Plan Outline. Another helpful website is VSA Arts of Delaware:
www.vsadelaware.org. VSA, formerly Very Special Arts, now stands for Vision, Strength, and
Artistic Expression. VSA Delaware is an affiliate of VSA’s national organization which was founded
in 1974 by Jean Kennedy Smith. VSA Delaware’s sole mission is to enhance the capabilities,
confidence and quality of life for individuals by providing life-long learning opportunities in the arts.
Their Cultural Access and Resources page has clear, helpful information and links for ADA
Organizational Plans.

     HUDSON COUNTY OFFICE OF CULTURAL & HERITAGE AFFAIRS/TOURISM
         DEVELOPMENT (HCOCHA) ADVISORY COMMITTEE SITE VISITS

The Peer Review Panel for Local Arts Program Grants for 2011 will review all submitted
Organizational ADA Plans, as part of the application review process. In addition, HCOCHA’s ADA
Advisory Committee will also review Organizational ADA Plans and will do site visits during the
year to assess facilities, programming, and re-grantee goals and achievability for accessibility. The
HCOCHA ADA Advisory Committee will advise groups on how best to accomplish these goals and
answer any questions regarding resources for achieving compliance with ADA for their programming
and facilities.




                                                45
ADA ORGANIZATIONAL PLAN FOR RE-GRANTEE GROUPS:


Organization Name:

Address:



Telephone:                                 Fax:


TDD:               Email:                          Website:

Name & Title of person completing this form:



Arts and humanities organizations – indicate your primary discipline:




Non-arts presenting organizations – indicate your primary mission:




Circle one: Does your organization:         rent          own   its office space




Circle one: Does your organization:         rent
                                            own     its exhibition/
                                                         performance space




                                      46
SAMPLE BUDGET SHEETS




        47
ORGANIZATION NAME:

                            FY 2011 LAP PROGRAM GRANT
                            FOR PROGRAMS AND SERVICE
                     JANUARY 1, 2011 TO DECEMBER 31, 2011
                   GRANT(S) PROPOSAL REQUESTED AMOUNT
                   TOTAL EXPENSES/BUDGET DECLARATION
                    Fill in Only What is Applicable to Your Proposal

GOS Grant Proposal Amount Requested          ________________


MG Grant Proposal Amount Requested           ________________



SP Grant Proposal Amount Requested           _8,000__________



TA Grant Proposal Amount Requested           ________________



TOTAL AMOUNT REQUESTED                       _8,000___________




TOTAL PROJECT EXPENSES BUDGET FOR MG, SP, or TA

                                             _$16,050.00_______


TOTAL ANNUAL OPERATING BUDGET (GOS ONLY)

                                             ________________




                                        48
ORGANIZATION NAME: FAKE ORGANIZATION NAME, INC.



                                                                SAMPLE
                            FY 2011 PROJECTED BUDGET – JANUARY 1, 2011 TO DECEMBER 31, 2011
                               SPECIAL PROJECT (SP) & MINI GRANT (MG) PROJECT EXPENSES


Expense                                                                                         Amount
1. Personnel
A. Project Administration                                                                         4,000.
B. Other (list)
C. Bookkeeping                                                                                     200.
D. Travel/Transportation
E. Fringe (If applicable)
2. Administrative Materials/Supplies
A. Office Supplies                                                                                 300.
B. Printing/Copying                                                                                200.
C. Postage/Mailing                                                                                 700.
D. Miscellaneous (list)
3. Facilities
A. Office Space/Performance/Exhibit Space Rental                                                 2,500.
B. Maintenance                                                                                   1,400.
C. Utilities                                                                                     2,000.
D. Telephone/FAX/Computer                                                                          100.
E. Insurance                                                                                       100.
F. Equipment Rentals
G. Other (list)
4. Marketing/Publicity
A. Advertising                                                                                    500.
B. Graphic Design                                                                                 500.
C. Printing                                                                                       500.
D. Other (list)
5. Artistic
A. Personnel (including designers, musicians, crew, actors, dancers, etc.)                      1,000.
B. Sets, Lighting, Costumes, Musical Instruments                                                1,000.
C. Royalties                                                                                      125.
D. Travel/Transportation                                                                          125.
E. Fringe
F. Insurance                                                                                      500.
G. Other (list)
6. Program and/or Site Accessibility Sign Language Interpreter                                   300.
7. GRAND TOTAL PROJECTED EXPENSES                                                             $16,050.




                                                                   49
ORGANIZATION NAME: FAKE ORGANIZATION NAME, INC.
                                                                 SAMPLE
                            FY 2011 PROJECTED INCOME – JANUARY 1, 2011 TO DECEMBER 31, 2011
                                        SPECIAL PROJECT (SP) & MINI GRANT (MG)
Source                                                                                                             Amount
PROJECTED EARNED INCOME
A. Admissions                                                                                                            800.
B. Subscriptions
C. Sponsorships/Other Cash Contributions                                                                                 300.
D. Fundraising/Special Events
E. Other Grants (DO NOT INCLUDE YOUR LAP REQUEST)                                                                      2,000.
TOTALPROJECTED EARNED INCOME                                                                                           3,100.

PROJECTED IN-KIND INCOME
Personnel
A. Project Administration                                                                                              3,200.
B. Other
C. Bookkeeping                                                                                                           100.
D. Travel/Transportation
E. Fringe
Materials/Supplies
A. Office Supplies
B. Printing/Copying                                                                                                     100.
C. Postage/Mailing
D. Miscellaneous
Facilities
A. Office Space                                                                                                         500.
B. Maintenance                                                                                                          200.
C. Utilities                                                                                                            250.
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other
Marketing/Publicity
A. Advertising                                                                                                          100.
B. Graphic Design                                                                                                       200.
C. Printing
D. Other
Artistic
A. Personnel (including designers, musicians, crew, actors, dancers, etc.)                                               300.
B. Sets, Lighting, Costumes, musical instruments, etc.
C. Royalties
D. Travel/Transportation
E. Fringe
F. Insurance
G. Other
Program and/or Site Accessibility
TOTAL PROJECTED IN-KIND INCOME                                                                                         4,950.

                                                                        A. FY 2011 MATCH
                                                                        (Total Earned Income + In-Kind Total Income)                _8,050._

                                                                                                                                +
                                                                        B. FY 2011 LAP GRANT REQUEST                              _8,000.
                                                                        TOTAL INCOME (add A+ B)                                  _16,050._
                                                                        GRAND TOTAL PROJECTED EXPENSES                          _$16,050.00
                                                                   50
ORGANIZATION NAME:

                            FY 2011 LAP PROGRAM GRANT
                            FOR PROGRAMS AND SERVICE
                     JANUARY 1, 2011 TO DECEMBER 31, 2011
                   GRANT(S) PROPOSAL REQUESTED AMOUNT
                   TOTAL EXPENSES/BUDGET DECLARATION
                    Fill in Only What is Applicable to Your Proposal

GOS Grant Proposal Amount Requested          __15,000________


MG Grant Proposal Amount Requested           ________________



SP Grant Proposal Amount Requested           ________________



TA Grant Proposal Amount Requested           ________________



TOTAL AMOUNT REQUESTED                       ___15,000________




TOTAL PROJECT EXPENSES BUDGET FOR MG, SP, or TA

                                             ________________


TOTAL ANNUAL OPERATING BUDGET (GOS ONLY)

                                             __$218,747_______




                                        51
ORGANIZATION NAME: FAKE ORGANIZATION NAME, INC.
                                                        SAMPLE
                    FY 2011 PROJECTED BUDGET - JANUARY 1, 2011 TO DECEMBER 31, 2011
                               GENERAL OPERATING SUPPORT (GOS) EXPENSES

Expense                                                                                                                Amount
1. Personnel
A. Administration (list titles & salaries) Artistic Director $29,000, Administrative Ass. $22,965,
(for hourly wages give amount and titles) Accountant $6,277, Payroll Service Fee                              59,779


B. Artistic (list titles & salaries, including designers, crew, etc.) Dancers $12,522, Instructors $26,791,
(for hourly wages give amount and titles)                            Production Ass. $9,410                   48,723

C. Support staff                             Grant Writer                                                       7,917
D. Travel/Transportation                                                                                          845
E. Fringe Administrative & Artistic                                                                             5,051
2. Administrative Materials/Supplies
A. Office Supplies                                                                                              3,459
B. Printing/Copying
C. Postage                                                                                                    1,500
D. Miscellaneous                 Interest $16,215, Depreciation $10,817, Bank Charges $1,087                  28,119
3. Production/ Exhibition
A. Sets/Costumes/Lighting/Musical Instruments Costumes $7,778, Uniforms $5,573, Supplies $4,055               21,527
                                                     Performance Exp. $4,121
B. Royalties                     Dues and Subscriptions $588, Contributions $260, Licenses $18                  867
C. Travel/Transportation
D. Insurance
4. Facilities
A. Office Space Rental/Performance/Exhibit Space Performance Space Rental                                      2,834
B. Maintenance            Repairs $13,492, Supplies $881                                                      14,373
C. Utilities                                                                                                   9,174
D. Telephone/FAX/Computer Telephone $3,772, Web Site $1,133                                                    4,905
E. Insurance                                                                                                   3,551
F. Equipment Rentals
G. Other (list)               Recital                                                                          2,032
5. Marketing/Publicity
A. Advertising                                                                                                 1,323
B. Graphic Design
C. Printing                                                                                                    1,768
D. Other (list)
6. Program and/or Site Accessibility               Ass. Listening Devices                                      1,000
(List, e.g. sign language, Braille print, etc.)
7. GRAND TOTAL PROJECTED GENERAL OPERATING EXPENSES 2011                                                      $218,747




                                                               52
ORGANIZATION NAME: FAKE ORGANIZATION NAME, INC.
                                                   SAMPLE
               FY 2011 PROJECTED INCOME – JANUARY 1, 2011 TO DECEMBER 31, 2011
                          GENERAL OPERATING SUPPORT (GOS) GRANT
Source                                                                                                    Amount
 Earned Income
 A. Admissions                                                                                   6,198
 B. Subscriptions                                                                              110,807
 C. Sponsorships/Other Cash Contributions                                                       21,244
 D. Fundraising/Special Events                                                                   6,813
 E. Other Grants (DO NOT INCLUDE YOUR LAP REQUEST)                                              58,685
 TOTAL PROJECTED EARNED INCOME                                                                $203,747

In-Kind Income
Personnel
A. Administration
B. Artistic
D. Travel/Transportation
E. Fringe
Administrative Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage
Production
A. Sets/Costumes/Lighting/Musical Instruments
B. Royalties
C. Travel/Transportation
D. Insurance
Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other
Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other
Program and/or Site Accessibility
TOTAL PROJECTED IN-KIND INCOME

                                                         A. FY 2011 MATCH
                                                         (Total Earned Income + In-Kind Total Income)       _203,747_

                                                                                                         +
                                                         B. FY 2011 LAP GRANT REQUEST                     __15,000.00

                                                         TOTAL INCOME (add A+B)                          _218,747.00
                                                         GRAND TOTAL PROJECTED EXPENSES                  $ 218,747.0

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ORGANIZATION NAME: FAKE ORGANIZATION NAME, INC.


                                                   SAMPLE
              FY 2011 PROJECTED BUDGET - JANUARY 1, 2011 TO DECEMBER 31, 2011
                               TECHNICAL ASSISTANCE (TA) EXPENSES



Expense                                                                             Amount
1. Consulting Personnel
A. Administrative                                                                  4,000.
B. Artistic
C. Support Staff
D. Travel/Transportation/Accommodations                                           1,000.
E. Fringe
2. Materials/Supplies
A. Office Supplies
B. Printing/Copying
C. Postage/Mailing
D. Miscellaneous (list)
3. Facilities
A. Office Space Rental/Performance/Exhibit Space
B. Maintenance
C. Utilities
D. Telephone/FAX/Computer
E. Insurance
F. Equipment Rentals
G. Other (list)
4. Marketing/Publicity
A. Advertising
B. Graphic Design
C. Printing
D. Other (list)
GRAND TOTAL PROJECTED TA EXPENSES                                               5,000.
YOUR FY 2011 TECHNICAL ASSISTANCE LAP REQUEST                                   5,000.




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