BAC Grassroots Arts Program Subgrant Application

I. Organization Information
Name of Organization/Artist
Contact Person's Name
Contact Person's Title
Mailing Address
City
State
Zip Code
County
Work Phone
E-Mail address
Website
Organization's EIN
Organization's UEI
Please give a brief description of your organization, including mission, board and staff composition, current arts programs and services, and number and kinds of people served. Public Schools and other large governmental or community agencies should provide a description of their arts program only rather than the entire organization.

Organizational Finances
Please attach a projected operating budget for the year in which grant funds will be used. Also, include completed operating budgets for the previous two years. Public schools and other large governmental or community agencies are exempt from this requirement. Please copy the totals from these attachments in the spaces below.
Last Year Actual FY
MM/DD/YR - MM/DD/YR
Actual Income (Last Year Actual FY)
$ xx,xxx
Actual Expenses (Last year Actual FY)
$ xx,xxx
Current Year FY
MM/DD/YR - MM/DD/YR
Income (Current Year FY)
$ xx,xxx
Expenses (Current Year FY)
$ xx,xxx
Next Year FY
MM/DD/YR - MM/DD/YR
Projected Income (Next Year FY)
$ xx,xxx
Projected Expenses (Next Year FY)
$ xx,xxx

II. Project Description
Grant Amount Requested
1234 Please round up or down to the nearest dollar. Do not include any punctuation (dollar sign, comma, or period)
Project Start Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Project End Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Project Narrative:

Please provide the narrative information below for the project you propose. Please be concise and as specific as possible.
Project Title or Summary Description
Project Goals
Description of intended participants and estimated audience numbers.
Location where the project will take place (please list all that apply):
Description of project activities:
Description of the artists to be involved in the project, how and why they were chosen and, if appropriate, the rate of payment for their services. (If you have not yet selected the artists, describe the kinds of artists you intend to involve and how you will select them.)
Description of how the project will be publicized and promoted to reach intended participants.
Description of how you will evaluate the project.

Project Budget

Please provide a projected budget for your proposed project utilizing the format below.

Project Expenses

Rows	Cash Expenses (Y+Z)	Grant Amount Requested (Y)	Applicant Cash Match (Z)
A. Personnel
1. Administrative Staff
2. Artistic Staff
3. Technical/Production Staff
.
B. Outside Fees and Services
1. Artistic Contracts
2. Other Contracts
.
C. Space Rental
.
D. Travel
.
E. Marketing
.
F. Remaining Project Expenses
.
G. Total Cash Expenses

Project Income

Rows	Cash Income
A. Admissions
.
B. Contracted Services Revenue
.
C. Other Revenue
.
D. Private Support
1. Corporate Support
2. Foundation Support
3. Other Private Support
.
E. Government Support
1. Federal
2. State/Regional
3. Local
.
F. Applicant Cash
.
G. Grant Amount Requested in this application
.
H. Total Cash Income (Must be at least equal to or more than Total Cash Expenses)

Grassroots Grant Application Checklist

Please use the checklist below to ensure that you have uploaded all the required documents. These documents are used, along with the application, to determine which grants will be awarded.
Please check if requested item is included and upload documents in the appropriate areas below:
Organization Annual Budget

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Proof of Non-Profit Status

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Letter of Commitment from the Non-Profit Partner, if applicable

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Board Member List for the Organization, Fiscal Sponsor, or Partner Organization

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Project Manager's Resume and/or Bio

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Artist's or Artists' Support and/or Bios, if applicable

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Sample Marketing Materials or Letters of Support (optional)

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Work Samples

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Audio Work Samples

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Video Work Samples

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Image Work Samples

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Written Work Samples

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Certification
We understand that failure to respond to any of the above items may adversely affect the consideration of this application. We certify that we are committed to the completion of the proposed project in compliance with legal requirements and granting procedures. We certify that the information contained in this application, including attachments and supporting materials, is true and correct to the best of our knowledge.
Name & Position of Authorizing Official
Signature of Authorizing Official
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature of Contact Person
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Fiscal Year