Do Not Staple
LOUISIANA DECENTRALIZED ARTS FUNDING (DAF) PROGRAM
Region 2 – Administered by the Arts Council of Greater Baton Rouge
Deadline June 1, 2008
For professional development and arts administration training to take place between October 1, 2008 and September 30, 2009
Read the 2009 DAF Guidelines thoroughly before preparing this application.
(< 75 words):
Amount Requested $
(See Guidelines P. 2):
If you are submitting two applications, indicate if this one is your first or second priority:
IMPORTANT! All applications must be postmarked or hand-delivered no later than 5:00pm June 1, 2008. Applications received 7 days after the
deadline are ineligible regardless of the postmark date. Applications must be typed on an official application form. Handwritten applications will
be declared ineligible. Applications may NOT be submitted by fax or e-mail; originals are required. Applications and Guidelines are available on
the Grants page of our website at www.artsbr.org. Applicants are encouraged to contact Laura Larkin, Grants Director & Community
Development Coordinator, at firstname.lastname@example.org or 225-344-8558 for guidance prior to the application deadline.
Workshops for DAF grant seekers are held in each of Region 2’s eleven parishes. See P. 2 of the DAF Guidelines for dates and times.
Note: An applicant match equal to at least 50% of the total project cost is required. The match may be applicant cash, cash from other funding or
sponsorship sources, the estimated value of in-kind services or items donated to you for the project, or any combination of the previous. See P. 14
of the 2009DAF Guidelines for the definition of ‘in-kind.’
Submit one copy of this application, the checklist with original signatures, and all supplemental materials to:
Arts Council of Greater Baton Rouge
427 Laurel Street
Baton Rouge, LA 70801
1. APPLICANT ORGANIZATION
Official Name of Organization:
Permanent Mailing Address: City/State/Zip:
Business Phone: Fax: Website:
Chief Administrator/Title: Federal Employer ID# (REQUIRED):
Contact Person: Contact Person E-mail:
Legislative Districts: House District Louisiana Senate District US Congressional District
Districts are available from your local registrar of voters, clerk of court, or online at www.legis.state.la.us/district/zipcode.asp
Year Founded: Community Served:
Statement as adopted by
your Board of Directors:
and past activities:
programs and services:
Sub-Applicant Info (to be completed by applicants using a Fiscal Agent only)
If you do not have nonprofit status and are using a Fiscal Agent to submit your application, the Fiscal Agent is the main applicant and you are the sub-
applicant. The Fiscal Agent is legally responsible for the Technical Assistance project and grant funds. Fiscal Agents and sub-applicants must be domiciled in
the same parish.
Official Name of Sub-Applicant Organization:
Permanent Mailing Address: City/State/Zip:
Business Phone: Fax: Website:
Contact/Title: Contact E-mail:
Brief Description of Sub-Applicant: If an organization, describe the organization’s mission and services it provides. If an individual, state your artistic
qualifications and experience. Describe the relationship between the Fiscal Agent and the Sub-Applicant.
2. THE PROPOSAL
(< 75 words):
Activities and Dates. List each specific training activity or consultancy and the exact date each will occur, not an overview or general range of dates. You
may also attach a detailed list with your supplemental materials. Activities must fall between October 1, 2008 and September 30, 2009.
Which consultant(s) will you OR if attending a conference/workshop,
hire to conduct the training? provide title and description:
What criteria were used in choosing this
consultant or type of training session?
Why is there a need for the technical
assistance at this time?
Who in your organization will
participate in the training?
(Give names and titles)
Number of individuals directly involved or impacted by the consultancy or training:
How will this training benefit the
participants, your organization
and the community?
DISCIPLINE(S) Select the primary discipline(s) involved with the consultancy or training .
Development of a cultural plan Allow staff/board to attend seminars, workshops, or
Assistance in designing a project other professional development program
Board development and recruitment Costs related to mentoring requested by an emerging
Documentation of art resources (artist, folk artist, organization
or art form) Museum methods or conservation training for artistic
Developing marketing plans (not historic) collections
Economic impact studies of the arts Use of media equipment and technology
Assistance in acquiring 501(c)(3) status
Documentation of applicant’s activities for
Where will the training
or consultancy take place:
Why was this particular
PARTIAL FUNDING We often receive more requests than we have funds available, so many applicants are awarded a portion of their
request rather than the full amount. If this happens, how will you modify your training or consultancy?
3. PRIOR DAF HISTORY (to be completed by previously funded DAF grantees only)
If you have received DAF funding in the past, you were required to submit a Final Report detailing your activities. Summarize the previous
application and Final Report for your most recently completed DAF grant below.
CHECK HERE if your organization is a first-time DAF applicant in 2009 or was a first-timer in 2008 with its program still in progress June 1.
Most recent completed year: Grant awarded: $ Grant expended: $
Project summary (< 75 words):
How were the grant funds
used? List amounts and uses:
Did the completed program
differ from the grant
agreement and/or original
application? If yes, how:
Did your organization submit Yes No If no, describe why:
its Final Report on time?
What methods were used to
evaluate the program?
What changes, if any, would you have
made to your completed program?
Is your 2009 application for a program similar to or a
continuation of your most recently completed program? Yes No
4. NARRATIVE - INSTRUCTIONS
Review P. 8 of the 2009 DAF Guidelines for Technical Assistance evaluation criteria by which your application will be scored.
Complete in no more than 2 typed, double-spaced pages with no smaller than 10-point font and ATTACH. Discuss each point in
the order listed.
Need and Impact – 40%
What are you proposing to do?
Why is there a need for technical assistance?
What do you hope to accomplish through this assistance?
What is your method of evaluating the assistance?
How will it affect the arts component of your programming? Note: Nonprofits whose mission is not arts related must evidence
how the technical assistance will benefit only the arts component of its programming.
How will the technical assistance aid in stabilizing or promoting the growth of the organization within the community?
Quality of Assistance – 40%
Briefly describe the training requested.
When and where will it happen?
Why were the consultants to be hired selected?
Briefly describe the consultant’s qualifications.
Briefly describe the degree and depth of training provided by the consultant services, workshop, or conference.
Administration and Budget – 20%
Who from your organization will be directly involved with the technical assistance?
Describe its cost effectiveness.
5. BUDGET - INSTRUCTIONS
Round all dollar amounts to the nearest $1.
All columns and rows should total correctly; Line A in Revenue should equal Column A in Expenses, Line B in Revenue
should equal Column B in Expenses, etc. Total Revenues must equal Total Expenses.
List all sources of revenue where indicated.
Under Expenses, Column A refers to expenses to be paid through the DAF Grant; Column B refers to expenses to be paid
through funds raised or provided by the applicant; Column C refers to expenses to be covered through donated items or
volunteer hours obtained; Total all columns on Column D.
In-Kind refers to the monetary value of time, materials, and other tangible goods or services contributed to the applicant at a
discount or free of charge by businesses and individuals. For example, an art supply store donates $200 worth of supplies to
the applicant free of charge, specifically for this technical assistance program; the applicant should list the $200 worth of art
supplies under in-kind contributions. Volunteers hours are counted at $10 per hour. In-kind contributions must be
expended only for the proposed activities and under the direct supervision of the applicant. An applicant must be prepared
to substantiate in-kind contributions (for example, time records for volunteers).
If supplies and materials exceed $500, a detailed budget breakdown must be included.
You may also attach more detailed budget information, although it does not substitute for the information on the Technical
Assistance Budget. This information will be forwarded to the panel with the application budget.
5. BUDGET Refer to P. 14 of the 2009 DAF Guidelines for budget definitions.
REVENUE List all income you expect to obtain to support this project.
A. DECENTRALIZED ARTS FUNDING GRANT REQUEST A. $
B.1. Earned Cash Income Projected
Admissions, Ticket Sales, Memberships, Subscriptions $
Contracted Services (workshops, presentations, etc.) $
Tuition and Fees $
Other (list): $
TOTAL Earned Income B.1. $
B.2. Other Cash Revenue
Applicant Cash $
Individual Contributions $
Fundraising (describe): $
Foundations (list): $
Business/Corporate Funds (list): $
Federal (list): $
State (list): $
Regional (list): $
Local (list): $
TOTAL Other Income B.2. $
B. TOTAL CASH INCOME (B.1. + B.2.) B. $
C. IN-KIND CONTRIBUTIONS (if you need more space, attach a separate list and write “see attached” below)
C. TOTAL IN-KIND CONTRIBUTIONS C. $
D. TOTAL REVENUE (A + B + C = D) D. $
EXPENSES List the expenses to be paid through grant funds, to be paid through applicant cash, and to be covered by in-kind contributions. Review
P.5 of the 2009 DAF Guidelines for expenses that may not be paid through this grant.
EXPENSE CATEGORY GRANT CASH MATCH IN-KIND MATCH TOTAL
Applicant Personnel – Administrative $ $ $ $
Applicant Personnel – Artistic $ $ $ $
Applicant Personnel – Tech/Production $ $ $ $
Outside Professional Services – Artistic $ $ $ $
Outside Professional Services – Other $ $ $ $
Space Rental $ $ $ $
Travel $ $ $ $
Marketing and Promotion $ $ $ $
Facility Rental $ $ $ $
Equipment Rental (list): $ $ $ $
Supplies and Materials* $ $ $ $
Postage/Shipping $ $ $ $
Insurance $ $ $ $
Fiscal Agent Fees (see Guidelines P. 4) $ $ $ $
Other (list): $ $ $ $
TOTAL EXPENSES $ $ $ $
*If Supplies and Materials exceed $500, attach a detailed breakdown. A B C D
Project Budget Summary
Grant Request: $
Total Project Expenses $
Matching Funds of Cash and In-Kind % of Total Project Cost (must be 50% or more)
6. PROVIDER OF SERVICES
This form is your primary opportunity to demonstrate the qualifications of the consultants or companies involved in your project.
Complete the following information for each individual consultant or company hired to provide Technical Assistance. Use a separate form for each;
extra Provider of Services Forms are available on the Grants page at www.artsbr.org. Fill out the form completely. Do not substitute resumes or attachments
for the Provider of Services Form. You may, however, include a complete resume, brochures, news clippings, videotapes, slides, photographs, CDs, or
cassette tape samples of work as supplemental to this form. Total fees for all Providers must correlate to total fees listed on the budget page.
Person or group to
Mailing Address: City/State/Zip:
Phone: Fax: E-mail:
Total travel costs (if
Professional Fee: $ per (hour, performance, etc.) not included in fee): $
How will the List monetary amounts. Total of all Provider Forms should relate back to the Budget.
Total Fee: $ fee be paid: $ DAF Grant $ Cash $ In-Kind
Describe the qualifications, including education, training, and related work experience for the individuals or organizations hired.
Description of Services:
Describe the exact services this individual or organization will provide for the project.
All applicants must submit the following with their applications:
Proof of nonprofit status: either an IRS letter determining nonprofit tax exemption under section 501(c)(3) of the Federal Tax Code or proof of
nonprofit status from the Louisiana Secretary of State. Governmental subdivisions (public schools, parish libraries, municipal governments,
state universities, etc.) are not required to submit. Proof of nonprofit status must be current and in good standing.
Proof of parish domicile: Certificate of Incorporation from the Louisiana Secretary of State, Commercial Division indicating the city in which
the applicant’s registered office is located. Must be the most recent address as indicated on the Annual Report filed with the Secretary of State.
Governmental subdivisions are not required to submit.
Chapter organizations must attach IRS documentation for the central organization and the chapter organization. A Letter of Support from the
central organization must also be attached.
Board of Directors list including names and addresses, identifying officers, ethnicity, and professional affiliation/job. Governmental
subdivisions are not required to submit.
Schools or projects working with schools must submit a Letter of Support from the local school board or principal.
Applications requesting funds for the creation of a new work of art must submit a sample of work that illustrates artistic merit of the artists
Previous DAF grant recipients must submit year-end financial statements or full audit for the most recent year. Grassroots volunteer
organizations may submit IRS Form 990 or a Financial Review by a Certified Auditor if they do not produce year-end financial statements or a
Optional, but strongly recommended: One set of supplemental materials, such as a scrapbook or documentation of artistic programs that
would benefit from the assistance, consultant samples of work, letters of support or reference, brochures describing the conference or
workshop that will be attended, etc. Include all supplemental materials with the application; do not send separately. Submit a self-addressed,
stamped envelope with correct postage if you would like your supplemental materials returned after October 1, 2008.
Project occurs between October 1, 2008 and September 30, 2009
Amount requested does not exceed parish funds available or maximum allowable request in the region
Application form is completely filled out with a complete Narrative, Provider of Services Forms for all individuals/groups involved,
Project Budget, and all required attachments.
Appropriate signatures signed in BLUE INK below (original signatures, not photocopies)
Do not staple, bind, or tape anything submitted including application, attachments, or supplemental materials. We must be able to photocopy
the items for distribution to the grants panel.
Retain a copy of the completed application form for your records.
Hand-delivered by 5:00pm or postmark stamped by the Post Office (not metered) by Friday, June 1, 2008.
The applicant hereby gives assurances to the Louisiana Division of the Arts, the Louisiana State Arts Council, and the Arts Council of Greater
Baton Rouge that: the applicant has read and understands all information contained in the FY 2009 Decentralized Arts Funding Program
Guidelines; the activities and services proposed in this application will be administered by the applicant organization; and any grant funds
received for this application will be used exclusively for payment of allowable expenditures incurred for proposed services, and such grant funds
will be administered by the applicant. The applicant will comply with all rules, regulations, laws, terms, and conditions described in the FY 2009
Decentralized Arts Funding Program Guidelines. The undersigned have been duly authorized by the governing authority of the applying
organization to submit this application to the Arts Council of Greater Baton Rouge as authorized by the Louisiana Division of the Arts and the
Louisiana State Arts Council. We hereby certify that all figures, statements, and representations made in this application, including any
attachments, are true and correct to the best of our knowledge.
Signatures are required and indicate that the signers have read the above “ASSURANCES” and agree to the grant conditions. “Authorizing Official”
should be the president of the board or other individual with the authority to enter into a legal contract on behalf of the agency (in the event of an
application from a school or school system, a duly authorized representative on behalf of the parish school board or private/parochial school board).
“Chief Fiscal Officer” should be the individual immediately responsible for the disbursement of funds for the project. “Project Director” is the
individual who will be directly responsible for the implementation of the activities of the above-described project. The application with the signatures
constitutes a legal document. One individual cannot sign all three lines. The signatures MUST be original (not photocopies) and all three spaces must
be completely filled in.
Authorizing Official (i.e. President, Chair, Executive Director)
Typed Name Title
Phone (day) E-mail
Chief Fiscal Officer (i.e. Treasurer, Accountant)
Typed Name Title
Phone (day) E-mail
Typed Name Title
Phone (day) E-mail
Keep a photocopy of this signed application for your records. Submit the ORIGINAL application to the Arts Council of Greater Baton Rouge.