PLRAC/McKnight FELLOWSHIP
Prairie Lakes Regional Arts Council
105 22nd Avenue NE, Suite A
Waseca, MN 56093-2612
(507) 833-8721 or (800) 298-1254
plrac@hickorytech.net * www.plrac.org
Fiscal Year 2016 Program Guidelines
July 1, 2015 – June 30, 2016
Application due: September 15, 2015
A. INTRODUCTION
The PLRAC/McKnight Fellowship provides professional mid-career and beyond artists with financial support
that enables them to further their work and their contribution to their communities. It is intended to recognize,
reward, and encourage outstanding individual artists in the region. Applicants for the PLRAC/McKnight
Fellowship are expected to demonstrate professional achievement in their disciplines. Professional mid-career
and beyond artist defined: professional achievement includes, but is not limited to: juried exhibitions,
performances, and publications. Eligible artists are beyond the “emerging” stage in their careers. They have
proved to be deeply engaged in their art form and may be ready to take a new “leap” in their career. They are
committed to being artists and to creating a body of work.
A Fellowship can support a broad range of study or activities, including exploration of new directions,
continuation of work already in progress, or accomplishment of work not financially feasible otherwise. A
Fellow may choose to take time for solitary work or reflection, engage in collaborative or community projects,
embark on travel or research, or pursue other activity that contributes to their life as an artist. Fellowship
candidates should propose a fellowship plan in only one art discipline; this may include dance, literature, media
arts, music, theater, visual art, etc. This program is made possible by funds provided by the McKnight
Foundation under a program designed and administered by the PLRAC, which serves Blue Earth, Brown,
Faribault, LeSueur, Martin, Nicollet, Sibley, Waseca, and Watonwan counties.
B. FELLOWSHIP AMOUNT AND DEADLINE
The Fellowship is for $3,000; and the application deadline is September 15, 2015. Applications must be
postmarked by the deadline date. Applications postmarked after the deadline will not be accepted. The
application will be reviewed at the November 19, 2015 board meeting. The fellowship period is one year and
the earliest starting date is approximately December 1, 2015.
C. APPLICATION ASSISTANCE
The Prairie Lakes staff is available to assist applicants in project development and answer questions about the
application process. Applicants are encouraged to contact the staff early in the planning process, and by August
31st at the latest. Staff assistance does not guarantee or imply that a fellowship request will be funded. The
content and accuracy of an application are solely the responsibility of the applicant. A Grant Writing video is
posted on YouTube; and Brenda Byron, PLRAC Director provides information on “Eligibility and How Artists
should complete their Fellowship Application”. Fellowship Link: http://youtube.com/watch?v=lQfhyM0wTx4
D. HOW TO APPLY
All proposals must be submitted on the official Application Form and signed by the artist. Do not reduce print
to less than 12 point characters. (Keep a copy for your records.) A complete application includes: the
Application Form, Artist’s Resume, Work Samples, List Describing Work Samples, Two Letters of
Recommendation and the Data Collection Form. Applications can be downloaded from our website on July 1,
2015 at www.plrac.org.
All applications must be computer generated Word document no handwritten Application will be accepted.
The application and its attachments must be mailed or emailed together as one packet by 9/15/15. Do not staple
the application or attachments. Work samples of CD, DVD or written materials will not be returned to the
applicant. Performers can also post your work sample on YouTube and copy the link on your application; and
also email it to the PLRAC office.
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E. ELIGIBILITY AND RESTRICTIONS
The Fellowship candidate must be 25 years of age, a U.S. citizen or have permanent resident alien status and
must currently reside in and have been a resident of the nine county PLRAC region for a minimum of twelve
months prior to application; and do not intend to relocate outside the 9-county region during the year of the
fellowship project. Residency is determined by: voting location, payment of state income taxes or a valid
Minnesota driver’s license listing a town in our region. If needed, the PLRAC may contact you for this
information. Fellowship recipient can apply every three years i.e. recipients in 2011 can apply again in 2014.
The maximum number of PLRAC Fellowships per artist is three.
Restriction. If the artist also submits a proposal to the Minnesota State Arts Board, McKnight Foundation or
other foundation for essentially the same project and budget and it is funded by both, the PLRAC will contact
the artist, and may request that the individual choose between the two grants. Two grants cannot be received
for essentially the same project and budget within the same year; this is referred to as double-dipping.
Fellowship candidates are not eligible if:
a. They have received a Fellowship directly from the National Endowment for the Arts, or major foundation
(like Bush, Jerome or McKnight) within the last three years.
b. They have received an Artist Initiative Grant from the Minnesota State Arts Board within the last two years.
c. They are a student enrolled full time in a degree granting program during the period of application or
completion of the Fellowship.
d. They are the recipient of a PLRAC/McKnight Emerging Artist grant of $1,000 during the same time period.
A Fellowship recipient must not have any outstanding reports due to Prairie Lakes Regional Arts Council.
e. The fellowship plan is not eligible if it includes any of the following activities or uses of funds:
1. payment of debts incurred before the grant is approved by the PLRAC board;
2. living or travel costs which are intended solely to provide experiences and not artistic growth;
3. activities involving any organization at which I am employed;
4. tuition, fees or work toward any degree;
5. development of curriculum plans, teaching materials, or teaching programs which are intended to be
used in the regular course of my employment;
6. establishing any type of arts organization;
7. self-publishing with vanity press, or other agencies, etc. ;
8. strictly commercial activities, such as those intended for retail or mass-market distribution (i.e. limited
edition prints, note cards, CD or DVD for musicians and performers, etc.;
9. activities that are essentially for the religious socialization of the participants or audience;
10. activities in primary or secondary level parochial schools; and
11. activities that attempt to influence any state or federal legislation or appropriation.
F. ELIGIBLE FELLOWSHIP PLANS OR PROJECTS
Fellowship Plans or Projects should have a clear beginning, middle and end. This may be a project that has
been on the “back burner” and the artist has not yet had the resources to complete it. It may be a second or third
project that will continue the artist’s path to success. The PLRAC/McKnight Fellowship MUST include a
public component. This may be a reading, a performance, an open house exhibition, etc. The artist should be
able to explain the project’s unique artistic or cultural impact on the larger community. Types of projects and
budget examples are listed on page 3.
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1. Production and Presentation - Costs involved in visual art show preparations, portfolio production, studio
time for producing a demonstration CD for a composer or musician, a DVD for a choreographer, editorial
assistance for a writer, etc.
2. Workshop, Training, Research or Mentorship – Registration fee, travel and other costs involved in advanced
training or apprenticeship with a professional artist. Mentorship with another artist requires that you also
submit their resume (showing background and expertise) and state what you hope to learn from them.
3. Supplies and Equipment - Purchase of supplies, materials or equipment necessary for the completion or
production of new work. (i.e. visual art: paint, brushes, canvas, matting and framing, etc.)
4. Creative time and living expenses – “Creative time” may be listed if you need time off of work to create
your artwork and living expenses for rent/utilities may also be part of the budget, but no more than 50% of
the fellowship.
Budget Examples
Briefly describe the expenses for your project, with specific amounts for each category. Mileage may be
reimbursed at .50 per mile. (i.e. Materials, supplies, equipment, registration fee, and travel. Editing & studio
time should list number of hours and hourly rate: __hrs. @ $__ per hr.) Mentorship with another artist – also
estimate hours, amount, and total expense. Include resume of mentor in your application. “Creative time” and
living expenses may also be part of the budget, if needed, but no more than 50% of the fellowship.
Creation of New Art Work for Exhibition
Art Supplies: paint ($150), brushes ($200), canvas ($400) =
Matting and framing (13 pieces @ $100)
Workshop fees, supplies and travel
Mileage 320 m. @ .50 = $160 + meals $50
Documentation: digital prints, CDs, etc.
Total
Literary Workshop and Editor for New Work
Literature Workshop Registration
Airfare $500 and Hotel for 3 days @ $150 per night
Mileage (320 m. @ .50 = $160) + meals $190
Editing (30 hrs. @ $30/hr.)
Miscellaneous supplies: paper, postage, etc.
Total
Literature Time and Living expense
Writer’s Retreat Location ($15 night x 30 days)
Loft classes (3 @ $150 each)
Mileage 540 m. @ .50 = $270 + meals $60
Editing (20 hrs. @ $25/hr.)
Living expense (Rent for two months @ $600 and
Utilities @ $70)
Total
$ 750
$1,300
$ 590
$ 210
$ 150
$3,000
$ 600
$ 950
$ 350
$ 900
$ 200
$3,000
$ 450
$ 450
$ 330
$ 500
$1,270
$3,000
Musician Studio Time for Recording New Work
XYZ Studio: 10 hours = $800 at nearby studio Estimate 30 hours cost $2,400
Music expense $250, Mileage $150 & Fee for additional musicians $200 = $600
Total $3,000
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G. REVIEW CRITERIA AND FELLOWSHIP REVIEW PROCESS
The applicant’s work samples should demonstrate artistic quality and should be created within the past four
years. All applications will be reviewed by the PLRAC board of Directors, who will consider the artist’s past
endeavors and current work, the impact the Fellowship may have on the applicant’s career and future directions,
and the difference the artist may make in the region as a result of the Fellowship. The three criteria are listed
below and there is a total of 30 points.
1. Artist’s past endeavors and current work. (0-10 points)
Has strong vision, creative energy, and perseverance. Documentation of artistic achievement through their
application, resume and work samples. Two letters of recommendation make reference to the applicant’s
artistic commitment.
2. Impact the Fellowship may have on the applicant’s career and future directions. (0-10 points)
Are they a professional mid-career and beyond artist, someone working independently who can demonstrate
that the creation of art is a primary endeavor? Is the Fellowship plan described well? Will the project serve as a
catalyst for their artistic and professional growth? Have they described well how it is important to their career
at this time? Is the budget realistic and do they have the ability to accomplish the activities within one year?
3. Public component. What artistic impact will the project have on the community? (0-10 points)
Does the artist plan to do an exhibit, lecture, performance, etc. in the region or state? This is required.
Are they seeking ways to connect in their arts discipline in the community or region, and how?
Review Process: Staff analyzes the application for eligibility, budget accuracy, clarity, and completeness,
and contacts the applicant if changes are required. Applications are reviewed and ranked by the board based
on the stated criteria. Applications are then recommended for funding according to their order of ranking and
the top ranked applications will receive funding. On average there are 16-20 applicants per year and the review
process is competitive. Therefore, artists that are very descriptive and specifically state how this fellowship
would advance their career and how they would showcase their art back in their community will stand out and
score higher in the review process.
H. ARTIST STATMENT
An Artist Statement is required as part of this application. List your one paragraph artist statement in question
4a. An artist statement is text that accompanies and explains the artist’s intentions of their body of work. A
strong artist statement supplements the visual information in the application so that the PLRAC board member
who is reading your application can better understand your work. Your artist statement should stand on its own
so that the reader can imagine what your work looks like even if they have not seen it.
Things that should be mentioned in your Artist Statement.
1. How - An explanation of the materials and media – What tools do you use? Be as specific as you can.
2. What - An explanation of the subject matter and concepts explored. What are you communicating? Again,
be specific. What sets your work apart from other work?
3. Why - Why these two aspects reinforce one another.
I. RESUME
An Artistic Resume is required as part of this application. The resume should not exceed two one-sided
pages in length. A resume could include any or all of the following: name, address, phone, education, training
and experience in the art form, work experience, volunteer or related art experience, public and private exposure
of your artwork (i.e. exhibitions, collections, commissions, published literary work, participation in music
groups or performances, etc.), grant awards, professional associations and interests.
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J. SUBMIT WORK SAMPLES
Remember that artistic merit is one of the primary criterions for the selection of fellowships. Your work sample
should represent your work to its best advantage. Work samples should be fairly recent (within the last four
years), and should support the intentions stated in your application. Do not submit original works. When
submitting JPG images on a CD, make sure the objects pictured are well lit and in focus. With a little care,
good quality video and sound recordings can be made on home equipment. In all cases, make sure the work
sample adequately reflects the quality of your work. Work samples will not be returned to the applicant.
If your artist project is multidisciplinary you can submit two types of work samples. For example:
(1) visual artist wants to demonstrate presentation of their work: Submit JPG images on CD and DVD video
presentation of artwork; (2) poet combines their work with photography, submit both CD and written sample; or
(3) playwright could submit 15 pages of script and 8 minute DVD of play excerpt.
Visual Artists: Submit maximum of 10 JPG images, minimum of 300 dpi on CD. Number from 1 through 10
in viewing order and label the CD with your name. For each JPG image provide a number, starting with 1 up to
10. Also include the title of the work, dimensions, and date it was completed.
Literary Arts: (fiction, non-fiction, prose, poetry, play, etc.) - 15 pages maximum. Must be computer
generated Word document and double-spaced, except poetry which can be single-spaced. Include cover sheet
with title, writer's name and a brief synopsis of the contents.
Performers: Singers, musicians, dancers, actors, etc. Submit visual or audible record of your work, maximum
of 8 minutes. A CD, DVD or link to YouTube video is acceptable. On the case of CD or DVD, clearly label
with your name, title of work(s), and length. Submit a written score (printed or computer generated) or a
condensed score.
K. WORK SAMPLE DESCRIPTION
The Work Sample Description is a one-page computer generated Word document list providing specific details
about your work samples.
a. Put your name, email and daytime phone number at the top of the sheet.
b. If you are a Visual Artist submitting Digital JPG images on a CD, list the artwork in numerical order 1
through 10 in viewing order with title, dimensions, medium, and completion date for each work listed;
c. If you are submitting Literary Samples (fiction, non-fiction, prose, poetry, plays, etc.): list the title, page
numbers, and the completion date of each work;
d. If you are submitting a CD or DVD: list titles of works and recording date of each work.
1. If the production represented by a CD or DVD involved others, explain your role in the work (for
example, a choreographer may or may not appear in submitted videotape);
2. If you are performing on a CD or DVD, give a description to help the panel identify you (for example,
“I’m the vocalist or banjo player in this musical piece”);
3. Indicate any technical instructions for presentation.
4. Performers can also post your work sample on YouTube and copy the link on your application; and also
email it to the PLRAC office.
e. You may also include a brief explanation of the work on your Work Sample Description. If you are a
multidisciplinary artist and submitting two forms of work samples also describe why.
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L. PAYMENT PROCESS
Upon notification of the Fellowship being awarded, the fellowship recipient must sign and return the Contract
within 30 days. After the contract has been returned to the Prairie Lakes office, a check for 80% of the grant
award is sent to the grantee one month prior to the project starting date. The grantee may claim the remaining
20% by submitting a Final Report within 60 days of the project's completion.
The Final Report is an extremely important document. If the fellowship plan has been carefully managed,
there should be little difference between the final plan & budget and the initial fellowship application
description & budget. The PLRAC realizes that as projects develop, some minor differences may arise, but
applicants should take every precaution to insure implementation, operation, and evaluation of the project as
promised. Fellowship recipients that fail to submit a required Final Report and receipts of their expenses within
the prescribed time with good cause, and subject to Council approval, will automatically be considered
ineligible for future funding.
M. FELLOWSHIP RESPONSIBILITIES
The fellowship recipient must:
1. Use fellowship funds only for the expenses listed in their application. Any significant revisions in the
fellowship plan must be requested and cleared, in advance and in writing, with the PLRAC’s Executive
Director.
2. Be responsible for completion of the fellowship and for proper management of funds. Documentation and
receipts for expenses must be submitted with the Final Report. The Final Report must be submitted within
60 days after the completion of the project.
3. Include the following credit line in all programs, postcards and publicity related to the project: "This
activity is made possible by a Fellowship from the Prairie Lakes Regional Arts Council with funds
provided by the McKnight Foundation."
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PLRAC/McKnight Fellowship Application
Prairie Lakes Regional Arts Council
105 22nd Avenue NE, Suite A, Waseca, MN 56093
(507) 833-8721 or (800) 298-1254
plrac@hickorytech.net * www.plrac.org
Fiscal Year 2016 Application
July 1, 2015 - June 30, 2016
Deadline: September 15, 2015
No handwritten applications will be accepted.
Set margins to .5 inch on all sides for form to print out correctly.
Do not staple the application or attachments.
FOR OFFICE USE ONLY
Application #
Date Received ____ / ____ / ____
Date of Award ____ / ____ / ____
Amount of Fellowship $
1. APPLICANT
Applicant's Name:
Address:
City:
State:
Day Phone #:
Evening Phone #:
E-mail Address:
Website:
2. FELLOWSHIP AMOUNT
3. PROJECT DATES
Zip:
$ 3,000
Type of Art:
START: December 1, 2015
Month/Year
END:
Month/Year
4. DESCRIBE THE FELLOWSHIP PLAN. In 2-3 paragraphs describe what you will accomplish during
the fellowship period. The fellowship period is one year, from December 1, 2015 to December 2016.
Answer questions A.-H. on no more than five computer generated Word document pages, using 12 point
font. Question #7 provides the list of Required Attachments for the application.
A. Provide your Artist Statement.
An artist statement is text that accompanies and explains the artist’s intentions of their body of work.
Your artist statement should stand on its own so that the reader can imagine what your work looks like
even if they have not seen it. Further details are provided in the guidelines, page 4.
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B. Provide a description of the artistic direction of your work, including any technical methods used, in 2-3
paragraphs.
C. What would you do with the time and money afforded by a fellowship? Why is your project important
to do now? Be specific about a budget and provide details and amounts. (See examples on page 3 of the
guidelines. Provide 2-3 paragraphs.)
D. How is your project original? What sets it apart from what other artists in your field are doing?
(provide 2-3 paragraphs)
8
E. How will the project serve as a catalyst for your artistic and professional growth? (provide 2-3
paragraphs)
F. What artistic and/or cultural impact will the project have on the larger community? (provide 2-3 paragraphs)
G. Who are the audiences for your work? Explain the public component of your project, whether this is a
performance, a reading, an open house exhibit, etc. Be specific about a location and dates for an exhibit
or performance and make initial calls to those places to secure dates in 2016. (provide 2-3 paragraphs)
H. Have you received an Artist grant previously from PLRAC? YES or NO
Have you received an Artist grant previously from other sources, MSAB or Foundation? YES or NO
If so, list the year and provide a sentence description of the project.
9
5. BUDGET Briefly describe the expenses for your project, with specific amounts for each category. Refer to
page 3 of guidelines, F. Budget description and examples.
A.
$
B.
$
C.
$
D.
$
Total $
6. ADDITIONAL BUDGET INFORMATION. If the project budget is larger than the request, indicate
whether other support is anticipated or already committed. Are you aware of other funding opportunities
and have you investigated them?
7. LIST THE NAMES OF YOUR TWO REFERENCES (Include address, city and email)
Note: Artists should also explain their fellowship project to their references so they can address it in their
letter.
1.
2.
CERTIFICATION
I certify that the information contained in this application is true and accurate to the best of my knowledge.
I have kept a copy of this Fellowship Application and all attachments for my records.
________________________________________________
Applicant Signature
_______________________
Date
8. CERTIFICATION FOR FELLOWSHIP
I understand that as a Fellowship applicant I am not eligible if any the following conditions exist:
a. I have received within the last 3 years a Fellowship directly from the National Endowment for the Arts, or
major foundation (like Bush, Jerome or McKnight); or an Artist Initiative Grant from the Minnesota State Arts
Board within last two years; b. I am a student enrolled full or part-time in a degree granting program during the
period of application or completion of the Fellowship; c. I am the recipient of a PLRAC/McKnight Emerging
Artist project grant of $1,000 during the same time period; d. I have an outstanding Final Report due to Prairie
Lakes Regional Arts Council.
Furthermore, the fellowship plan is not eligible if it includes any of the following activities or uses of
funds: 1. payment of debts incurred before the grant is approved by the PLRAC board; 2. living or travel costs
which are intended solely to provide experiences and not artistic growth; 3. activities involving any organization
at which I am employed; 4. tuition, fees or work toward any degree; 5. development of curriculum plans,
teaching materials, or teaching programs which are intended to be used in the regular course of my
10
employment; 6. establishing any type of arts organization; 7. Self-publishing with vanity press, or other
agencies, etc. ; 8. strictly commercial activities, such as those intended for retail or mass-market distribution
(i.e. limited edition prints, note cards, CD or DVD for musicians and performers, etc.; 9. activities that are
essentially for the religious socialization of the participants or audience; 10. activities in primary or secondary
level parochial schools; and 11. activities that attempt to influence any state or federal legislation or
appropriation.
I have read the list of Eligibility Requirements for the Fellowship of $3,000 and I fit all of the criteria.
Yes: No:
Fellowship Eligibility Requirements and restrictions of this fellowship.
_____ 1.
I am a mid-career or beyond practicing artist, applying as an individual.
_____ 2.
I have been a resident of the 9-county area served by Prairie Lakes Regional Arts Council, for a
minimum of 12 months.
_____ 3.
I am at least 25 years of age.
_____ 4.
I am a United States citizen or I have permanent resident alien status.
_____ 5.
I do not intend to relocate my legal residence outside the 9-county PLRAC region during the year
of the fellowship project. Note: If grantee leaves the PLRAC region before completion of the
Fellowship, the funds must be returned.
_____ 6.
I am submitting a complete and accurate application on a current year’s PLRAC application form,
with all information requested.
_____ 7.
I have not received a PLRAC Emerging Grant within the past twelve months.
_____ 8.
I do not have an outstanding Final Report due to the PLRAC.
_____ 9.
I will make any events related to this project open to the general public.
_____10.
If I also submit a proposal to the MN State Arts Board, McKnight Foundation or other foundation
for essentially the same project and budget and it is funded by both, Prairie Lakes will contact me
and may request that I choose between the two grants. Two grants cannot be received for
essentially the same project and budget within the same year; this is referred to as double-dipping.
9. REQUIRED ATTACHMENTS (A-E). Do not submit other supplementary information.
A. Artistic Resume or profile of no more than 2 single-sided pages in length, which includes: Arts
education and/or arts training, arts experience, arts related employment, public presentations,
publications, commissions, awards, honors, or special achievements.
B. Submit two Letters of Recommendation from two individuals in the project’s art discipline who are
familiar with your work. Also let them know what your Fellowship project is. The letters must include
the name, address, phone number and the professional qualifications of the letter writers.
C. For applications related to a “mentorship or advanced study”, include Resume for the Artist with whom
applicant wishes to study or receive professional services from.
D. Work Sample Description Page and Artistic Work Sample. (Information on pages 4-5)
E. RAC Grant Data Collection Form
Please Email or mail the application and required attachments to plrac@hickorytech.net or Prairie Lakes
Regional Arts Council, 105 22nd Avenue NE, Suite A, Waseca, MN 56093 by September 15, 2015.
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RAC GRANT DATA COLLECTION FORM
TO THE APPLICANT: This form is used to gather information about grant applicants to the Minnesota Regional Arts
Councils (RACs). The data is maintained by the Minnesota State Arts Board in cooperation with the RACs, and may be
distributed to others in accordance with the Minnesota Data Practices Act. Complete information is necessary to ensure
the reliability of our data.
1.
APPLICANT INFORMATION
Date
Legal name of organization or individual
Professional or other name
NA
Address
City
State
Zip code
MN House district
U.S. Congressional district
Day phone
E-mail address
Contact person name and title
NA
County
Fiscal agent name (if applicable)
NA
2. SPECIAL CHARACTERISTICS:
For individuals applying (optional)
Select any combination that applies describing
your racial/ ethnic characteristics. This
information is not made public.
For organizations applying
Select the one code that best represents 50% or
more of your staff or board or membership
3. STATUS:
Select the one code which best
describe the applicant’s legal
status
American Indian/Alaska Native (N)
Asian (A)
Native Hawaiian/Pacific Islander (P)
Black/African American (B)
Hispanic/Latino (H)
White (W)
Other ______
01 Individual
02 Organization-Nonprofit
03 Organization-Profit
04
05
For individuals, mark these items if they apply
(optional)
Disability (I)
Older Adult - 60+ (S)
Veteran (V)
06
Government-Federal
Government-State (includes public
schools)
Government-Regional
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Union/Professional Association
School-District
School-Parent/Teacher Assn
School-Elementary
School-Middle
School-Secondary
School-Vocational or Technical
School-Other (incl Community Ed)
College/University
Library
Historical Society/ Commission
Humanities Council/Agency
Foundation
Corporation/ Business
Community Service Organization
Correctional Facility
Health Care Facility
Religious Organization
0 1
4. INSTITUTION:
Select the one code which best
describe the applicant
0 1
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
Individual artist
Individual non-artist
Performing Group
Performing GroupCollege/University
Performing Group-Community
Performing Group-Youth
Performance Facility
Museum (Art)
Museum (Other)
Gallery/Exhibition space
Cinema
Independent Press
Literary Magazine
Fair/Festival
Arts Center
Arts Council/Agency
Arts Service Organization
Legal name of individual
12
07
08
09
99
Government-County
Government-Municipal
Government-Tribal
None of the Above
5. DISCIPLINE:
Select one code which
best describes the
applicant’s primary area of
interest in the art
(e.g. ballet 01A)
05 Visual Arts —general
05A
experimental
05B
graphics (include
drawing, cartooning,
printmaking, book arts)
01 Dance—general
01A
ballet
01B
ethnic/jazz/
folk-inspired
01C
modern
02 Music—general
02A
band
02B
chamber
02C
choral
02D
new-experimental,
electronic
02E
ethnic/folk-inspired
02F
jazz
02G
popular
02H
solo/recital
02I
orchestral
03 Opera/Musical Theater—general
03A
opera
03B
musical theater
04 Theater—general
04A
theater, in general
04B
mime
04C
puppetry
04D
theater for young people
04E
storytelling
10C
playwriting/
scriptwriting
09 Media Arts —general
09A
film
09B
audio
09C
video
09D
technology/
experimental
09E
screenwriting
10 Literature—general
10A
fiction
10B
non-fiction
10C
playwriting/
scriptwriting
10D
poetry
11 Interdisciplinary (include
collaborations & performance
art)
05D painting
05F sculpture
06 Design Arts —general
06A architecture
06B fashion
06D industrial
06E interior
06F landscape architecture
06G urban/ metropolitan
07 Crafts—general
07A clay (includes ceramics)
07B fiber (includes basketry) 12 Folklife/Traditional Arts, in general
07C glass
12A
Dance
07D leather
12B
Music
07E metal
12C
Crafts and
07F paper
visual arts
07G plastic
12D
Oral traditions
07H wood
13 Humanities
07I
mixed media
14 Multi-disciplinary
08 Photography (include holography)
15 Non-arts/non-humanities
PROJECT ACTIVITY
6.
Adult Artists Participating Record the number of adult artists expected to be directly involved in providing art or artistic services for
these grant activities.
7.
Adult Audience Benefiting Record the number of adult audience expected to benefit directly from these grant activities (excluding
employees, paid performers, artists participating, children/youth, and broadcast figures). Do not double-count repeat attendees.
8.
Children/Youth Benefiting Record the number of children and youth under the age of 18 expected to participate in and/or benefit
directly from these grant activities, or were included in the audience (excluding broadcast figures). Do not double-count repeat
attendees.
9. Project Discipline Using the same discipline coding listed above, select one category which best describes the grant activity.
10. For organizations applying, total organization expenses for most recently completed fiscal year:
$ ____________
FY ________
TO BE COMPLETED BY REGIONAL ARTS COUNCIL STAFF ONLY
Total Project Revenue (cash only-include grant request)
Total Project Cost (cash only)
In-Kind Contributions
$
$
$
FISCAL YEAR
2016
GRANT REQUEST $3,000
SOURCE OF FUNDS
RAC
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RECOMMENDED $ _____
State General Fund
$ _____
ACHF Arts & Arts Access
$ _____
APPLICATION #
09152015_____
AWARDED
Federal
$ _____
ACHF Arts Education
$ _____
Other
$ _____
ACHF Arts & Cultural Herit $ _____
GRANT PROGRAM
Production Assistance
Sponsorship Activity
Other
$ _____
General Operating Support
Organization Arts Project
Organizational Management Support
Arts in Education School Residency
Arts Scholarship
Individual Artist
APPLICATION WITHDRAWN
APPLICATION INELIGIBLE
Reason for ineligibility or withdrawn application
Comments
Project Description ____________________________________________________________________________________________
ALL INFORMATION ON THIS FORM HAS BEEN REVIEWED AND IS COMPLETE AND CORRECT.
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