WARREN COUNTY CULTURAL AND
HERITAGE COMMISSION
SHIPPEN MANOR
8 BELVIDERE AVENUE
OXFORD, NJ 07863
(908) 453-4381
LARGE TYPE TEXT EDITION AVAILABLE
CALL (908) 453-4381
ARTS GRANT APPLICATION
FY 2015
This application is step 1 of a 3 step process:
1.) Application
2.) Grant Agreement
3.) Final Report
PLEASE REFER TO INSTRUCTIONS AND GLOSSARY PRIOR TO
COMPLETING THIS APPLICATION.
ONLY ACCESSIBLE ARTS PROJECTS WILL BE FUNDED.
Return signed hard copy typed original and six copies to:
WCCHC
8 Belvidere Avenue
Oxford, New Jersey 07863.
Deadline: 4 PM, Monday, October 20, 2014
Emailed or faxed applications WILL NOT be accepted.
ORGANIZATION___________________________AMOUNT REQUESTED $_________
PART I
ORGANIZATION INFORMATION
Organization Name:
Street Address:
City, State, Zip:
Phone #:
Email: _______________ Federal I.D.
*Project Director:
Phone #:
Email:
*Authorizing Official:
Title:
Phone #:
Email:
*Must be two (2) individuals directly involved with this arts project.
PART II
APPLICATION SUMMARY
A. Artistic Discipline Code Number:
01 Dance
A. Ballet
B. Ethnic/Jazz/Folk
C. Modern
02 Music
A. Band - Does not include jazz or popular
B. Chamber
C. Choral
D. New - Include experimental, electronic
E. Ethnic/Folk Inspired
F. Jazz
G. Popular
H. Solo/Recital
I. Orchestral - Includes Symphonic
03 Opera/Music Theater
04 Theater
05 Visual Arts
06 Design Arts
07 Crafts
08 Photography
09 Media Arts
10 Literature
11 Interdisciplinary
12 Folk Arts
13 Humanities
14 Multi-Disciplinary
B. Type of Grant Requested (Check one)
SPECIAL PROJECT (SP)
GENERAL OPERATING SUPPORT (GOS) Arts Organizations Only
TECHNICAL ASSISTANCE (TA) Arts Organizations Only
2015 WARREN COUNTY CULTURAL AND HERITAGE COMMISSION
ARTS GRANT APPLICATION
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ORGANIZATION___________________________AMOUNT REQUESTED $_________
PART II
APPLICATION SUMMARY - CONTINUED
C. Funding History: Has your organization previously received funds from the
NJSCA or WCCHC?
If yes, list grants, amounts and years.
PART III
NARRATIVES
ALL BULLETED POINTS MUST BE INCLUDED.
A. ORGANIZATIONAL NARRATIVE

Organization’s Mission Statement.

Organization’s proposed arts project expected impact on the community.

How does the organization ensure ADA compliance?
B. ARTS PROJECT NARRATIVE

Describe the proposed arts project.

Provide arts project dates and descriptions of arts events.
C. ARTS PROJECT FUNDING

How are matching funds to be raised?

How are requested art grant funds to be spent?
D. ADMINISTRATION/PARTICIPATING ARTISTS

Describe how the project will be administered.

Write a brief description of participating artists and their contact
information. DO NOT SEND PRINTED WEB PAGES OR BROCHURES!
2015 WARREN COUNTY CULTURAL AND HERITAGE COMMISSION
ARTS GRANT APPLICATION
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ORGANIZATION___________________________AMOUNT REQUESTED $_________
PART III
NARRATIVES - CONTINUED
E. MARKETING PROPOSAL AND EVALUATION

Describe how the art project will be promoted.

Describe the audience to be served.

How will the proposed art project be evaluated?
Include recent support material such as press clippings, program coverage,
promotional materials, flyers, etc. DO NOT SEND PRINTED WEB PAGES OR
BROCHURES! LIMITED TO 4 PIECES.
Include separately any awards, recognitions, interviews, etc.
The WCCHC must be provided with a schedule of your grant supported
events two weeks before any public announcements. If tickets are required
you must provide the WCCHC with four complimentary tickets.
NOTE: All support material should include the following statement
in a legible font size:
"Funding has been made possible, in part, by the Warren
County Cultural and Heritage Commission."
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ARTS GRANT APPLICATION
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ORGANIZATION___________________________AMOUNT REQUESTED $_________
PART IV
BUDGET PAGE INSTRUCTIONS FOR: January 1, 2015 to December 31, 2015.
Application Budget, page 8, a separate file.
1st COLUMN: Category descriptions.
Income Sources:
1. Admissions: Funds received from admission charges.
2. Sales: Money received through sales of goods or services.
3. Other Support *:
2015 OTHER SUPPORT
TYPE OF SUPPORT
IDENTIFY & EXPLAIN
$$ VALUE
Individuals
Businesses
Memberships
Other
4. Total Income: Total lines: 1+2+3
5. Cash on Hand: Available funds, usually surplus from previous year.
6. WCCHC Grant: “ACTUAL BUDGET A & B” – funds received in previous years.
7. Total Funds: Total lines: 4+5+6
Expense Sources:
8. Arts Organizations’ Personnel: Salary and wage costs for permanent employees
of your arts organization; i.e. paid director, officers, etc.
9. Artistic Fees: Fees paid to artists for professional services.
10. Other Fees *:
2015 OTHER FEES
TYPE OF FEES
IDENTIFY & EXPLAIN
$$ VALUE
Tech Support
Transportation
Hospitality
Other
11. Rentals: For artistic programming; i.e. lights, sound system, space, etc.
12. Marketing: Advertisement and or promotional costs.
13. Office Expense: Non-salary office expenses; phone, mail, ink, copies, etc.
14. Misc *: Itemize any other expenses. If greater than 5% of total budget, explain
here:
2015 OTHER EXPENSES
TYPE OF EXPENSE
IDENTIFY & EXPLAIN
$$ VALUE
15. Capital: Capital expenses for artistic programming may be used as part of your
Match. Grant funds may not be used for capital expenses.
16. Total Expenses: Total lines: 8 +9+10+11+12+13+14+15.
17. Total Funds: Amount from line 7 above “Total Funds”.
18. Surplus/ (Deficit): Compare lines 16 and 17 to determine surplus or (deficit). If
budget is in balance, this line will equal zero.
2015 WARREN COUNTY CULTURAL AND HERITAGE COMMISSION
ARTS GRANT APPLICATION
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ORGANIZATION___________________________AMOUNT REQUESTED $_________
PART IV
BUDGET INSTRUCTIONS – CONTINUED
19. Total In-kind *: Identify and itemize “in-kind” contributions:
2015 IN-KIND CONTRIBUTIONS
TYPE OF DONATION
IDENTIFY & EXPLAIN
Volunteer hours
Services
Site
Other
$$ VALUE
NOTE - Columns 2-6: There are two subsections in each column income and expenses.
BUDGET A: FY 2013 (1/1/13-12/31/13): Actual income and expenses from all sources
including grant funds.
BUDGET B: FY 2014 (1/1/14-12/31/14): Actual income and expenses from all sources
including grant funds.
BUDGET C: FY 2015 (01/01/15-12/31/15) PROJECTED USE OF ART GRANT FUNDS.
NOTE: COMPLETE ONLY ONE BUDGET PROPOSAL BELOW
 D: FY2015 – SINGLE ART PROJECT; proposed details of the
projected 2015 art project income and expenses.
OR

E: FY2015 – ARTS ORGS. & MULTIPLE PROJECTS;
proposed details of the projected 2015 art project income and
expenses.
REMINDER: Include only arts programs that benefit; Warren County residents, are not
fund raisers, and are hosted at an ADA accessible site.
2015 WARREN COUNTY CULTURAL AND HERITAGE COMMISSION
ARTS GRANT APPLICATION
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ORGANIZATION___________________________AMOUNT REQUESTED $_________
PART V
AUTHORIZATION
Sign below declaring that, to the best of your knowledge, the Application Budget
page 8, including all information is correct.
I understand these eight (8) pages constitute this application.
Note: Two signatures are required.
I certify that all statements in this application are true to the best of my knowledge; and I
hereby release the Board of Chosen Freeholders of the County of Warren and the Warren
County Cultural and Heritage Commission, their employees, and agents from any liability
and/or responsibility concerning any submission of materials to the program. I further
certify any funds received under the Warren County Cultural and Heritage Arts Grant
Program will be used exclusively for the purpose set forth in this application, and I will
notify the Warren County Cultural and Heritage Commission immediately in the event my
organization receives funding for the year 2014 directly from the New Jersey State Council
on the Arts. I understand and agree submission of an application signifies intention to
comply with Title VII of the Civil Rights Act of 1964 (Pl 88-352), with Labor Standards
under Section (1) of the National Foundation on the Arts and Humanities Act of 1965
(PL185-209), Title IX of the Education Amendments of 1972, and Section 504 of the
Rehabilitation Act of 1973.
Organization Name
Project Director’s Printed Name – as listed in PART I
/
Project Director’s Signature
Title
/
Date
Authorizing Official’s Printed Name – as listed in PART I
/
Authorizing Official’s Signature
Title
2015 WARREN COUNTY CULTURAL AND HERITAGE COMMISSION
ARTS GRANT APPLICATION
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/
Date