MUNICIPALITY OF ANCHORAGE
ARTS ADVISORY COMMISSION
2013 GRANT APPLICATION
Deadline: December 13, 2012
SECTION A: GENERAL INFORMATION
ORGANIZATION NAME: (LEGAL INCORPORATED NAME. MUST MATCH TAX RETURN)
TAX ID NO:
ADDRESS: CITY: ST: ZIP:
MAILING ADDRESS (IF DIFFERENT):
ORGANIZATION PHONE: ORGANIZATION FAX:
PRIMARY CONTACT (MUST BE AN OFFICER OR DIRECTOR):
PRIMARY CONTACT PHONE:
PRIMARY CONTACT EMAIL:
SECONDARY CONTACT (DOES NOT NEED TO BE OFFICER OR DIRECTOR):
SECONDARY CONTACT EMAIL:
1. This application is being completed on a Calendar Year (CY) or Fiscal Year (FY) basis.
2. When does your fiscal year end?
3. Grant amount requested from the Municipality of Anchorage for CY13: $
4. For CY13 (or FY 12/13), what percentage of the organization’s total budget does the municipal
funding request represent? %
5. What percentage of the organization’s total budget for CY13 (or FY 12/13) relates to its activities
within the Municipality? %
6. Are you requesting any other funds from Municipal agencies? No Yes if yes, please
7. Funding History:
Municipal Arts Grant Funding: Organization’s Total Revenues:
Municipality of Anchorage – Arts Advisory Commission Grant Application 2013 Rev 10/02/12 Page 1 of 4
SECTION B: ORGANIZATION DESCRIPTION AND PURPOSE
1. Insert the mission statement of your organization:
2. Briefly summarize the history of your organization. (maximum 250 words)
3. Briefly summarize the organization’s program or project schedule for the upcoming season.
(maximum 250 words)
4. List of artists/classes/events for upcoming season.
5. Does the program/mission of the organization service, benefit, or educate the youth of
Anchorage, and if so, how? (Maximum 250 words)
6. Estimate the number of persons affected by your program(s) in the following categories:
Estimate Number of Persons Affected by FY011/12 or CY12 FY/CY13
Artists or Performers
B. Workshops or Classes
C. Free Events, Other Programs, Exhibits,
D. Fundraisers (numbers attending)
Artists, Performers, Presenters
E. Volunteers (all except Board of Directors
and paid staff)
F. Board of Directors
# of Directors
Total Board Cash Donations
G. Total Possible Audience/Student Capacity
All Events, Programs, Workshops,
7. Briefly discuss the organization’s endowments, savings, and real property, including present
principal value, and policies regarding disposal of funds on those assets. Include endowments
whose sole beneficiary is the organization.
Municipality of Anchorage – Arts Advisory Commission Grant Application 2013 Rev 10/04/12 Page 2 of 4
8. List Estimated “In-Kind” donations of goods and services received. Please be sure to include
all subsidies from Municipality of Anchorage and the fair market value (rents, services, etc. with
value of $500 or over)
Item In-Kind Donations
9. Attach the Organization’s following budgets for expenses and income:
CY2012 OR FY2011/2012
LAST COMPLETE FISCAL YEAR
PRIOR COMPLETE FISCAL YEAR
10. Attach the Organization’s projected budgets for expenses and income for which the
organization is seeking funding: CY2013 OR FY2012/2013. Provide explanation for variations
of 5% or more from previous year budget.
11. Attach balance sheet for most recent completed fiscal year.
12. Attach a list of yearly salaries for all staff positions:
13. List of the Board of Directors including names and mailing addresses. Indicate officers and
14. A copy of an Alaska Certificate of Incorporation, Business License, or Certificate of Good
15. IRS Letter of Determination – For change of status or first time grantees only.
16. Provide Application Feedback: (Maximum 250 words)
Thursday, December 14, 2012, is the application deadline for funding year 2013. The original
application plus 9 paper copies must be received (not on disk, not faxed) at 632 West 6th Ave, City
Hall, 8th Floor, Suite 840, Mayor’s Office, Anchorage, Alaska, before 5:00 p.m. ADT and be date
stamped. Bring the organization’s file copy and have it stamped as a receipt. All copies need to be
3-hole punched for binders. Please do not use staples in original or copies. Double sided printing is
LATE OR INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
Municipality of Anchorage – Arts Advisory Commission Grant Application 2013 Rev 10/04/12 Page 3 of 4
I certify that the information contained in this application, including all attachments and supporting
material, is true and correct to the best of my knowledge.
Must be signed by an Officer of the organization.
Please type or print legibly the following:
Municipality of Anchorage – Arts Advisory Commission Grant Application 2013 Rev 10/04/12 Page 4 of 4