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ISCM Membership Support Fund App


									ISCM Members Support Fund Application Form (English Version) Page 1

International Society of Contemporary Music Members Support Fund Application
Applications to the ISCM Member Support Funds must be made through an ISCM National Section or Associate Member regardless of whether the applicant has been proposed for the ISCM Event by the National Section/Associate Member. Signatures from both the individual and a representative of the ISCM National Section / Associate Member are required. The ISCM expects that all avenues of funding will be sought after by the applicant, and applications made to the ISCM Member Support Fund only for expenses not covered by other resources. Personal Data:
(Funds can only be requested for individuals who are citizens or official landed immigrants of the country applying)

Funds requested for: Name: _________________________________ Address: ________________________________________________ __________________________ ________________________________________________ Phone/Fax: _________________________________ Email: _____________________________________ National Section / Associate Member: _________________________________ ISCM Event: Description of Event: _________________________________
(eg. World Music Days)

Location of Event: _____________________________________ Dates of Event: _______________________________________ Nature of participation: _________________________________
(eg. selected composer)

Costs of Attending the Event (in Euros): Travel: _________________ Accommodation: _________________ Per Diem: _________________ Other travel fees: _________________
(eg. visa fees taxes)

TOTAL COST: _________________ Anticipated Support from other Sources (in Euros): National Grants: _________________ Local Grants: ___________________ ISCM National Section: _________________
(or Associate Member)

Personal Contribution: _________________ Other: _________________ TOTAL SUPPORT: _________________ Amount Requested from the ISCM Members Support Fund: 300 Euros 500 Euros Signatures: Applicant: ________________________________________________ Date: ______ ISCM Representative: ______________________________________ Date: ______ Name (please print): ____________________________ Position in Organization: _________________________ Phone/Fax: ____________________________ Email: ________________________________

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