Clone of ACTC Grant Application

2027 ACTC GRANT APPLICATION
Organization Name
Organization Also Known As
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which fund are you applying for?
Is Your Organization a 501(c)(3)? Must be a 501(c)(3) to qualify.
Non-Profit Incorporation Date
Employer Identification Number (EIN)*
*Organization must fit within applicable National Taxonomy of Exempt Entities (NTEE) IRS tax codes for arts, cultural and humanities nonprofit organizations.
Total Fiscal Summary
Organization Budget for Last Completed Fiscal Year:
Organization Budget for Present Year:
Organization Budget for Projected Year:
Financial Documentation

Applicants must provide the following current financial reports: 1). Year-to-Date P&L Statement 2). Current Balance Sheet 3). Last completed fiscal year Profit & Loss report and Balance Sheet 4). Most recent filed IRS 990
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Applicant Contact

First NameLast Name
Title
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
What have you accomplished this last year?
What was your attendance your past fiscal year and how did you measure it?
ACTC Grant Agreement
Under penalties of perjury, I declare that I have examined information contained in the application for this grant and accompanying documents and, to the best of my
knowledge and belief, they are true, correct and complete, and I am in fact eligible for funding under this grant program. I am aware that the submission of any false information or omission of any pertinent information resulting in the false representation of a material fact may subject me to civil and/or criminal penalties for filing of false public record and/or forfeiture of any funding awarded under this program. I further declare that I have reviewed the ACTC Overview Guidelines and acknowledge my responsibility as a grant applicant to become familiar with these guidelines and that failure to comply could result in ineligibility for the grant program now and in the future.

I understand that should I have any questions regarding these guidelines, I may contact ACTC. I further understand that all documents submitted become the property of ACTC.
Full Name
Title
Initial
Date

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

2027 ACTC GRANT APPLICATION

Total Fiscal Summary

Financial Documentation

ACTC Grant Agreement