Final Report by Levone


Grants to Organizations Contract Program Requirements


Submitting the Final Report is the last contractual requirement for each Grants to Organizations Program grant. The Final Report documents the services provided, meets the requirements of the State of Washington for audit compliance, fulfills the requirements for WSAC's funding from the National Report Deadlines for PSP Endowment for the Arts (NEA), and provides statistics used for reports to the state budget office, the state legislature, the NEA and Congress.
Required Attachments The Final Report, with

attachments, must be received by the Grants to Organizations Program at the Commission office, no later than February 1, 2010 for Round One grants, and August 2, 2010 for Round Two grants.

A complete Final Report includes: 1) the Final Report form; 2) documentation of the actual expenditure of the PSP grant funds, (i.e., copies of cancelled checks, bills for the expenses, or proof that the final budget was approved by the board via board meeting minutes or a letter from the board president documenting the approval); AND 3) published material from the organization giving credit to WSAC and/or the NEA for the financial support provided by this grant. Penalties · Failure to Report
General Instructions

Download the Final Report form from the WSAC website: Select the link Grants to Organizations, then select Final Reports. Download to your computer, fill out and print out. The Final

Future funding and payment of any pending applications, grants or contracts is contingent upon the timely receipt, evaluation and acceptance of the Final Report by the Grants to Organizations Program. The Glossary of Terms Final Report is a contractual obligation. WSAC General Guidelines "Glossary of by the Definitions for terms used here can be found in the Failure to submit a Final ReportTerms," published deadline will found inin aProjectpenaltyProgram section of the agency website. grant. Failure to submit a Final Report in a timely result the 10% Support deducted from any subsequent Mail the Final Report To: and reasonable manner mayalso result in the denial of eligibility of future applications, withholding of Questions? Grants to Organizations Program · FINAL REPORT PHONE 360/753-3858 grant payments until the report obligations are met, or the denial of funding for a set period of time. If a WASHINGTON STATE ARTS COMMISSION FAX 360/586-5351 grantee's contract must be turned over to the Attorney General's office for collection, the grantee will not P.O. BOX 42675 be OLYMPIA WA 98504-2675 for one fiscal year after the date of resolution of the collection. eligible for funding
Street Address: 711 Capitol Wy. S. #600, Olympia, WA 98501

Grants to Organizations Program

Contract #2010

Excel users note: Please type all information in the cell directly to the right of its label.


Applicant Organization Legal Name: Organization STREET Address: Street Address City: County : Street Address State: Zip Code+4: Organization MAILING Address: Mailing Address City: County : Mailing Address State: Zip Code+4: Organization Business Area Code/Phone: Organization Business Area Code/FAX: Organization's Web Site Address: Managing Director's First Name: Managing Director's Last Name: Mr./Ms.: Managing Director's Title: Managing Director's Area Code/Phone: Managing Director's E-Mail Address: Authorizing Official's First & Last Name: Mr./Ms.: Authorizing Official's Title: Grant Contact Person's First Name: Grant Contact Person's Last Name: Mr./Ms.: Grant Contact Person's Title: Grant Contact Person's Area Code/Phone: Grant Contact Person's E-Mail Address:

2. Fiscal Agent (if applicable) Fiscal Agent Legal Last Name: Fiscal Agent Authorizing Official: Fiscal Agent Area Code: Signatures of persons named above - use blue ink: Managing Director: Authorizing Official: Grant Contact Person:


Date: Date: Date:

REQUIRED ATTACHMENTS: 1) Copies of canceled checks or bills for the expenses covered by WSAC grant funds. As an alternative, proof that the final project budget has been approved by the Board of Directors may accompany the Final Report. Submit board meeting minutes or a letter from the President of the Board that document this approval. 2) Attach published material giving credit to the WSAC and/or the NEA for financial support under this grant award.

Final Report - Page 1

Applicant Name:

Report Narrative
PROJECT EVALUATION Describe how you did or did not meet your organization's desired outcomes for this project. Was it an artistic success? Did you reach your target audience? What benefit did you provide to the public or to your community? ---


Credit to the Washington State Arts Commission (WSAC) is required in published material regarding this PSP grant, and if you received federal funds, credit to the National Endowment for the Arts (NEA). Describe in the text box when and where credit to WSAC or the NEA was published? REQUIRED: Attach example of printed credits to WSAC and/or the NEA.

Final Report - Page 2

Applicant Name:

Final Project Support Budget
(For "Staff Support" Budget, use Page 4)

Admissions Contracted Services Other Revenue Corporate Support Foundation Support Individual Support Other Private Support Government - not WSAC Other WSAC Grants Applicant Cash


$ $ $ $ $ $ $

$ $ $ $ $ $ $ Income Sub-Total: $ $ Actual Total Project CASH INCOME: $


PSP STATE Grant Award


Personnel Administrative Personnel Artistic Personnel Technical and Production Outside Artistic Fees Outside Fees Other Tech/Prod Expenses Space Rental Travel Marketing Remaining Expenses

DESCRIBE $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $


Actual Total Project CASH EXPENSES: $
REQUIRED ATTACHMENT: To meet state audit requirements, submit copies of canceled checks or bills for the expenses covered by WSAC grant funds. As an alternative, proof that the final project budget paid has been approved by the Board of Directors may accompany the Final Report. Submit board meeting minutes or a letter from the President of the Board that document this approval.

- $

Total In-Kind Donations to the Project

Final Report - Page 3

Applicant Name:

National Information Standard

(All grantees must complete this section including Page 5)

The National Endowment for the Arts requires the following information for all grantees and programs of the Washington State Arts Commission. The statistics and answers should be from the project or events covered by Project Support, Challenge America or Staff Support funds.

Project Descriptors
If any of the descriptors below comprise a significant portion (50% or more) of the grant's activities mark with a "Y" for "Yes". If none apply, or if the descriptors apply to a small or indeterminate portion of your activities, mark with a "N" for "No". ( 50% or more ) Services related to ADA/504 Compliance or other activities that increase access to the arts for persons with disabilities.


International: ( 50% or more ) Programs or activities supporting any of the following: grantees visiting other countries, foreign artists visiting the USA, any cultural exchange program, linkages with artists or institutions in other countries, or establishing/administering international programs in your own agency. Presenting/Touring: ( 50% or more ) Grants or services resulting in the movement of artists and artworks for performances, readings, screenings, exhibits, etc., in different geographic areas. Mark this descriptor if funds awarded were used for either the hosting/presentation of works originating outside of the grantee community or for the fees paid to artists or arts organizations that were, themselves, touring in different areas.
( 50% or more ) Grants or services using technology for the creation or dissemination of artworks or the use of technology for organizational management purposes.


Youth at Risk: ( 50% or more ) Grants or services designed primarily to serve at-risk youth. Include arts-related intervention programs (for violence, drug/alcohol abuse and crime) as well as other creative programming specifically involving at-risk youth as primary project participants or beneficiaries. Older Adults: ( 50% or more ) Grants or projects designed specifically to serve older adults. Include creative programming involving older adults as the primary project artists, participants or beneficiaries, as well as arts-related programs in elder care settings, senior recreation centers or retirement residences. Health/Healing: ( 50% or more ) Programs or activities using the arts specifically to promote good physical or mental health or to aid in healing. May be applied to programs serving individuals as well as institutions or communities (such as community healing efforts in response to natural disasters or other tragedies). Economic Development: ( 50% or more ) Grants or services specifically designed to use the arts as an economic development tool, to support business improvement districts through the arts, to stimulate the creation of creative-sector job opportunities or to integrate the arts into existing economic development programs, polices or initiatives. Cultural Heritage Tourism: ( 50% or more ) Activities that promote cultural events specifically to tourist populations and/or use arts, heritage or history offerings as traveler destinations. Include initiatives and partnerships that integrate culture into tourism development plans.
(Continue to Page 5)

Final Report - Page 5

Applicant Name:

Arts Education:
If your project includes a systematic educational effort with the goal of increasing the participant's knowledge of and/or skills in the arts with measurable outcomes, please respond as: 01 If it is 50% or more of this project's activities, 02 If it is less than 50% of this project's activities If the program involves no systematic educational effort or a general public performance or exhibit where students are simply in attendance, code it as: 99 No arts education If you wish to add a code for the ages of the students, add one of these letters after the code: A K-12 students;

B Higher educations students; C Pre-kindergarten children (including teachers and artists) D Adult learners Enter Total Number of Individuals Benefiting:
The total number of individuals who were directly involved in the funded activity as artists, non-artist project participants or audience members between the grant or project start and end dates. Figures should include totals from the Artists Participating and Youth Benefiting fields. If actual figures are not available, please just estimate! Do not leave this blank!

Number of Youth Benefiting:
The total number of children and youth (those under 18 years old as students, participants, or audience members) benefiting directly from the funded project. This figure should be one portion of the total number reported as "Individuals Benefiting" noted above.

Number of Artists Participating:
The total number of artists directly involved in providing art or artistic services specifically identified with the project. Include living artists whose work is represented, regardless of whether the work was provided by the artist or by another institution.

Washington State Artists Participating:
Of the total artists involved, how many were Washington artists?

Number of Project Events:
How many arts opportunities were available to the public? A single concert is an event; two concerts are two events. An art exhibition is a single event, but can be counted as more than one event day. A festival may be one event day, but may include over thirty distinct events on that single day. Give a fair count of the number of events. Number of public events: Number of event days:

(End of form! Thank you! )

Final Report - Page 6

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