Docstoc

2013 Arts Grant Application - 1

Document Sample
2013 Arts Grant Application - 1 Powered By Docstoc
					                                          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)


INCORPORATION DATE:
TAX ID NO:
ADDRESS:              CITY:             ST:       ZIP:
MAILING ADDRESS (IF DIFFERENT):
ORGANIZATION PHONE:                             ORGANIZATION FAX:
PRIMARY CONTACT (MUST BE AN OFFICER OR DIRECTOR):
TITLE:
PRIMARY CONTACT PHONE:
PRIMARY CONTACT EMAIL:
SECONDARY CONTACT (DOES NOT NEED TO BE OFFICER OR DIRECTOR):
TITLE:
SECONDARY PHONE:
SECONDARY CONTACT EMAIL:
_______________________________________________________________________________
1. This application is being completed on a                     Calendar Year (CY) or        Fiscal Year (FY) basis.
    (CHECK ONE)
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
   list:

7. Funding History:
   Municipal Arts Grant Funding:                                    Organization’s Total Revenues:

    CY08                                                  FY07-08/CY08
    CY09                                                        FY08-09/CY09
    CY10                                                        FY09-10/CY10
    CY11                                                        FY10-11/CY11
    CY12                                                        FY11-12/CY12




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
         Programs                                                                 (Actual)
         A. Performance/Productions/Events
              Paying Audience
              Complimentary Tickets
              Artists or Performers
         B. Workshops or Classes
              Paying Students
              Complimentary Students
              Instructors
         C. Free Events, Other Programs, Exhibits,
            Readings
         D. Fundraisers (numbers attending)
              Audience
              Artists, Performers, Presenters
         E. Volunteers (all except Board of Directors
            and paid staff)
              # Volunteers
              # Hours
         F. Board of Directors
              # of Directors
              # Hours
              Total Board Cash Donations
         G. Total Possible Audience/Student Capacity
              All Events, Programs, Workshops,
                Classes

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
        Property

        Rent/Services

        Discounted Rates

        Board In-Kind

                                        Total:

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
    positions held.

14. A copy of an Alaska Certificate of Incorporation, Business License, or Certificate of Good
    Standing.

15. IRS Letter of Determination – For change of status or first time grantees only.

16. Provide Application Feedback: (Maximum 250 words)


APPLICATION DEADLINE

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
encouraged.

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
CERTIFICATION:

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.

                                                          Authorizing Official:


                                                          Signature: ___________________________________

                                                          Please type or print legibly the following:
                                                          Name:
                                                          Title:
                                                          Date:




Municipality of Anchorage – Arts Advisory Commission Grant Application 2013   Rev 10/04/12      Page 4 of 4

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:0
posted:3/2/2013
language:Unknown
pages:4