Pennsylvania Partners in the Arts Creative Sector Flex Fund Application

Pennsylvania Partners in the Arts Creative Sector Flex Fund Application
Applicant/ Fiscal Sponsor:
Name*

First NameLast Name
FEIN (9 digits, no spaces/ hyphens)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Web URL*
PA House District*
PA Senate District*
Contact Name*

First NameLast Name
Contact Title*
Contact Phone*
Please enter a valid phone number.
Contact Email*
example@example.com
Fiscal Sponsored Organization (if applicable):
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
Web URL*
Contact Name*

First NameLast Name
Contact Title*
Contact Phone*
Please enter a valid phone number.
Contact Email*
example@example.com
Financial Information
Total revenue for your most recently completed fiscal year as reported on your IRS Form 990 line 12 (revenue means all contributed and earned cash income, and realized income from investments, as applicable. Do not include in kind). If your revenue is below $50,000 and you submit a postcard 990 OR you are a non-arts organization with an arts program, you MUST attach Board/Committee financial statements for your most recently completed TWO fiscal years. The program financial statement must include program revenue, including contributed and earned income and income realized from investments, as applicable, and expenses.*
Enter dollar amount above.
Job Information
Current Number of Full-Time Equivalent (FTE) jobs, where FTE is calculated as a minimum of 35 hours per week. As applicable, include contractors or leased employees providing consistent services under your organization’s direct supervision. For non-arts organizations, provide the number of FTEs working within your arts program. To the extent that your FTE count varies during the year due to seasonality of programming or operational needs, provide your anticipated high mark of FTE jobs through the end of the grant period. As applicable, include contractors or leased employees providing consistent services under your organization’s direct supervision.*
Enter number of FTE above.
Narrative
Applicant Overview
1. Provide your mission statement. If you represent an arts program within a larger non-arts organization that does not have an arts-specific mission, provide an artistic statement and the goals of your arts program.*
2. Briefly Describe the community you serve and why.*
Community Value
Artistic Offerings and/or services that strengthen its community culturally, educationally, and/or economically.
3. Over the past year, how did your artistic offerings and/or services support your community culturally, educationally, and/or economically? (Your response may include a description of the value provided to your community, whether adding to its cultural landscape, educational opportunities, or economic opportunities promoted directly or indirectly within your community).*
Artists and artistic offerings and/or services involve and are meaningful to the community being served.
4. Over the past year, describe how artistic decisions were made and by whom. How did you know your artistic products and/or services were meaningful to your community? *
Relevant arts learning opportunities for community members.
5. Over the past year, describe how you defined and determined the impact of your arts learning initiatives within your community. *
Diversity, Equity, and Inclusion Value
Apart from being audience members or beneficiaries, community members are central to the design of the applicant's work.
6. Over the past year, describe tour community's involvement in your work and its feedback related to your artistic products and/or services.*
Plans and action-oriented practices toward diversity, equity, inclusion, and access in ways that are relevant to your community, including reaching new audiences.
7. Over the past year, describe your organization's plans and work to advance diversity, equity, inclusion and/or access. How did you know that plans and actions were relevant to your community?*
Stewardship Value
Planning processes appropriate to the organization, mission, and goals.
8. Describe your most recently completed planning process, including who was involved. Describe the key findings and goals that followed this planning process, and how you track and measure progress.*
Capacity to carry out programs and projects as planned.
9. Over the past year, how did you ensure that you were able to carry about your programs or projects? To what degree were you able to carry out programs as planned?*
Appropriate financial planning and oversight practices.
10. Describe your financial planning and oversight practices, including who participates in and is accountable for financial management and organizational oversight. Describe the financial condition of your organization and key actions taken to ensure adequate resources are available to carry out your mission or arts program.*
Required Attachments
IRS Determination Letter confirming nonprofit 501(c) status. (does not apply to Local Governments)

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For arts organizations:
Attach your TWO most recently submitted form of 990 (or 990-N or 990-EZ) IRS tax filings. If your revenue is below $50,000 and you submit a postcard 990 you MUST attach Board/Committee financial statement for your most recently completed TWO fiscal years. The program financial statement must include program revenue, including contributed and earned income and income realized from investments, as applicable, and expenses.

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For non-arts organizations:
Attach a Board/Committee approved arts-specific program financial statement for your most recently completed TWO fiscal years. The program financial statement must include program revenue, including contributed and earned income realized from investment, as applicable, and expenses In-kind is not included.

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For those applicants being fiscally sponsored:
Attach the fiscally sponsored entities' art-specific program financial statement for your TWO most recently completed fiscal years. The program financial statement must include program revenue, included contributed and earned income and income realized from investments, as applicable, and expenses.

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Attach the Sponsorship Agreement between the fiscal sponsor and the entity being sponsored. This must include: - duties and responsibilities of each party, - the term of the agreement, - termination of provisions, - ownership of intellectual property, - dispute and indemnification clauses, -and the method of the holding and distribution of funds.

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LLCs MUST also submit its' Certificate of Organization-Domestic Limited Liability Company filed with the Pennsylvania Department of State Bureau of Corporations and Charitable Organization's --At least three organizers must be listed in the Certificate of Organization.

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All organizations must:
Provide a succinct (no more than one page) list of arts activities (for example: 3 concerts; 2 workshops; 5 exhibitions) - THIS WILL BE SHARED WITH THE PANEL. You may submit up to three links to artistic content or programmatic highlights you generated during the previous two years. (Note: links can be to file sharing sites (Google Drive, DropBox, etc.), YouTube, Vimeo, websites, Instagram accounts, etc.) Please be sure to grant proper access, as applicable.

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Representations and Warranties
The Applicant makes the following representations and warranties to Elk County Council on the Arts. Effective as of the submission of thisApplication, the Applicant hereby represents and warrants to the best of itsknowledge and belief that:

1. The information the Applicant presents in this application and any attachments thereto is true and correct.

2. The Applicant has ongoing operational expenses.

3. The Applicant has not received an audit finding in respect of its status as a going concern and expects to remain a going concern at least through the grant term.

4. The Applicant expects to deliver arts-related programming or services and fulfill its obligations under the grant, whether virtually or in person, during the applicable grant term.
Signature*

Clear
PLEASE MAKE SURE ALL DOCUMENTS ARE ATTACHED BEFORE SUBMITTING.

IF ANY REQUIRED ITEMS ARE NOT SUBMITTED, THE APPLICATION WILL NOT BE CONSIDERED FOR FUNDING.
Should be Empty:

Pennsylvania Partners in the Arts Creative Sector Flex Fund Application

Applicant/ Fiscal Sponsor:

Fiscal Sponsored Organization (if applicable):

Financial Information

Job Information

Narrative

Applicant Overview

Community Value

Artistic Offerings and/or services that strengthen its community culturally, educationally, and/or economically.

Artists and artistic offerings and/or services involve and are meaningful to the community being served.

Relevant arts learning opportunities for community members.

Diversity, Equity, and Inclusion Value

Apart from being audience members or beneficiaries, community members are central to the design of the applicant's work.

Plans and action-oriented practices toward diversity, equity, inclusion, and access in ways that are relevant to your community, including reaching new audiences.

Stewardship Value

Planning processes appropriate to the organization, mission, and goals.

Capacity to carry out programs and projects as planned.

Appropriate financial planning and oversight practices.

Required Attachments

For arts organizations:

For non-arts organizations:

For those applicants being fiscally sponsored:

All organizations must:

Representations and Warranties

PLEASE MAKE SURE ALL DOCUMENTS ARE ATTACHED BEFORE SUBMITTING.