BIPOC Artist Exchange and Activation Initiative Grant Application

BIPOC Artist Exchange and Activation Initiative Grant Application
ARTIST INFORMATION
FULL NAME*

First NameLast Name
E-MAIL*
example@example.com
HOME ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE NUMBER
ARTIST INSTAGRAM
ARTIST WEBSITE
EVENT INFORMATION
EVENT NAME*
EVENT LOCATION*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EVENT DATE*

MonthDayYear
Date
EVENT DESCRIPTION
EVENT/ORGANIZER WEBSITE (Please describe the event, its purpose, and how it will showcase your work to the New Hampshire community
TOTAL DURATION OF THE EVENT(hours)*
Event Registration Fee
ESTIMATED TRAVEL DETAILS
TRAVEL MILES (One Way)*
ELIGIBILITY AND PROOF
Please confirm that you identify as BIPOC and reside in New England.*

YesNo
Please elaborate on how you identify if you wish to do so. (Optional)
Are you willing to provide proof of home location if requested for travel compensation?*

YesNo
Are you willing to provide proof of attendance at the event to receive reimbursement?*

YesNo
Grant Request(Calculated)
Grant Coverage:
- The grant covers travel expenses using the IRS standard mileage rate at $0.655 per mile roundtrip.
- It also covers the labor of the artist during the event, calculated at $20 per hour.

Maximum Grant Amount:
The maximum grant amount is $300.
Total Travel Reimbursement (round trip)
Total Labor Hours for Event
Total Estimated Grant Request
Does the above calculation seem correct? If not, why?*
Artist Statement
Please briefly share your artistic background, the significance of your work, and why you believe participating in this initiative is important.
Should be Empty:

BIPOC Artist Exchange and Activation Initiative Grant Application

ARTIST INFORMATION

EVENT INFORMATION

ESTIMATED TRAVEL DETAILS

ELIGIBILITY AND PROOF

Grant Request(Calculated)

Artist Statement