2021-2022 Arts Education Application

Arts Education Application

Cover Page
Applicant Data
Name of School
Contact Person Name

First Name Last Name
Contact Person Title
Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
County
Work Phone
Please enter a valid phone number.
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Fax
Email
example@example.com
Website
Arts Program Information

Please give a brief description of your school’s current arts programs and services, how many contact hours students have in arts classes, and number of special arts presentations each year.
Budget Statements

Please complete the information on the following years’ arts program budgets in your school:
FY 2019-2020 year-end report
Income: $blanks
Expense: $blank
FY 2020-2021 year-end report
Income: $ blanks
Expense: $ blank
FY 2021-2022 budget
Income: $ blanks
Expense: $ blank

Arts Education Application

Summary Page
School Name
2021-2022 Grant Request : $ blanks

Grant Amount Received 2020-2021: $ blank
Program Start Date
Program End Date
Briefly describe your project activities using no more than 25 words in the space below:
Narrative

Please attach an application narrative following the instructions in the Composing the Narrative Section of the Arts Education Grant Guidelines.
Narrative file upload

Cancel of
Certification

We certify that the information contained in this application, including all attachments and supporting materials, is true and correct to the best of our knowledge (Please upload image files of appropriate signatures).
Name of Principal

First Name Last Name
Signature of Principal (please upload image of appropriate signature)

Cancel of
Date
Name of Project Coordinator

First Name Last Name
Position of Project Coordinator
Signature of Project Coordinator (please upload image of appropriate signature)

Cancel of
Date

Arts Education Application

Budget Summary Page
School Name
Budget Summary of Proposed Project

This page is only a budget summary. You must also provide an itemized budget as an attachment.
Project Expenses

A. Personnel

B. Outside Fees and Services

	Cash Expenses =	Grant Amount Requested +	Applicant Cash Match
Artistic Contracts
Other Contracts

	Cash Expenses =	Grant Amount Requested +	Applicant Cash Match
C. Space Rental
D. Travel
E. Marketing
F. Remaining Project Expenses

	Cash Expenses =	Grant Amount Requested +	Applicant Cash Match
TOTAL CASH EXPENSES

	Cash Income
A. Admissions
B. Contracted Services Revenue
C. Other Revenue

D. Private Support

E. Government Support

	Cash Income
Federal
State/regional (not including this request)
Local

	Cash Income
F. Applicant Cash
G. Grant Amount Requested (in this application)

	Cash Income
H. TOTAL CASH INCOME (must at least equal Total Cash Expenses, Item G above).

Arts Education Application

Attachment Page
Applicant Attachments

Please upload the following additional attachments to complete your application:
Detailed project budget

Cancel of
Artist names and websites

Cancel of
Letters of support from collaborating schools, if applicable

Cancel of
Should be Empty:

Arts Education Application