AFM Local 33 MPTF Application for Co-Sponsors

AFM Local 33, Tucson Federation of Musicians

P.O. Box 50745, Tucson Arizona 85703 | 520-352-9558 | local33afm@gmail.com
Music Performance Trust Fund Application for Co-Sponsors

Please submit this form to AFM Local 33 no sooner than 8 weeks and no later than 5 weeks before the date of the performance.

In addition to this form, please also submit a W-9, a signed Terms and Conditions Agreement, and a Cost Breakdown Sheet with details regarding costs and calculations of the performance. Your application must include all materials in order to be complete. You may attach the additional documents to the end of this form (preferred) or email them to local33afm@gmail.com within 24 hours of completing this form. Please also submit L-1 or L-2 contracts as necessary.
Basic Information
Project Name*
Date of Performance*

MonthDayYear
Date
Is your organization a registered non-profit (501 c3)?*

YesNo
Will the performance be streamed?*

YesNo
Will the performance be streamed on MPTF's Facebook Page? *If streamed, performances must be streamed on the MPTF Facebook page ONLY. If you are streaming, please upload a fully executed Live Stream Agreement and an approved Streaming Proposal.*

YesNo
Funding Information
Where is the check going?*

Payroll ServiceSponsor
Sponsor Organization Name*
Sponsor Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sponsor FIN/EIN*
Sponsor Contact Name*
Sponsor Email*
example@example.com
Sponsor Phone Number*
Please enter a valid phone number.
If payment will be submitted to a payroll service, please fill out the relevant information below.
Payroll Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payroll Service Federal Tax ID/EIN
Payroll Service Contact Name
Payroll Service Phone
Payroll Service Email
example@example.com
Performance Details
Is this event free and open to the public?*

YesNo
Please describe the details of the performance including its goal in 250-500 characters*

0/500
Type of Music*
Choices: big band, chamber group, soloist, concert band, country, folk, jazz, oldies, opera, pop/rock, R & B, show tunes, symphony, world music
Type of Performance*
Choices: Education, Medical, or Community
Type of Venue*
Choices: art center/festival, block party, city square, community center, house of worship, library, medical facility, museum, parade, park, patriotic holiday venue, school, senior citizens center, commercial establishment, theater/concert hall
Attendance Estimate Range*
Include Minimum Number and Maximum Number of attendees
Rehearsal Information
Is there a rehearsal?*

YesNo
Please complete the rest of the rehearsal information section if you are including a rehearsal in your MPTF proposal.
Date, Time, and Location of Rehearsal
Note: MPTF will only pay for one rehearsal
Rehearsal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Total Number of Musicians at Rehearsal
Total Rehearsal Wages
Performance Information
Performance Start and End Times*
MPTF funds up to 2 hours
Leader/Group Name*
Performance Location*
Performance Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Total Number of Musicians*
Is there a leader? (type yes or no)*
Leader Scale*
Type 0 if there is no leader
How many side musicians?*
Side Musicians Scale*
Scale wages for all musicians other than leader
Total wages to be paid for this performance, including the amount paid for the rehearsal*
Do not include pension and cartage. Cartage may be notated in the Cost Breakdown Sheet.
Grand total cost of this performance*
Submit the cost of funds that are eligible for MPTF approval. For example, if you have more than one rehearsal, do not include the cost of the extra rehearsals in the total since MPTF will only cover one rehearsal. For more information on what costs are eligible to be covered by MPTF, refer to the terms and conditions sheet or contact the TFM at local33afm@gmail.com.
Amount you are requesting from MPTF*
If your application is approved, MPTF will cover up to 50% of approved costs. We recommend filling in this amount for 50% of the grand total cost. Make sure your grand total cost only reflects funds that are included in this application.
Completed W-9

Cancelof
Cost Breakdown Sheet

Cancelof
Signed Terms and Conditions Agreement

The MPTF Terms and Conditions Agreement can be found on our website at www.local33afm.org
Cancelof
Should be Empty:

AFM Local 33, Tucson Federation of Musicians

Basic Information

Funding Information

If payment will be submitted to a payroll service, please fill out the relevant information below.

Performance Details

Rehearsal Information

Performance Information