Artists' Fellowship Inc. Financial Assistance Application

PLEASE NOTE: Limited financial aid is intended for artists and their dependent families who are in need of assistance due to sickness or distress, causing an emergency crisis. Requests for educational or working grants are not eligible, nor do we award "fellowships" for study, art supplies, travel, or exhibitions.
Long term support should not be expected.

Please take a moment to read this before filling in your application.

CHECKLIST: The following material must accompany this application. We suggest you gather this information in one place on your desktop for easy uploading:

1. Taxes: Please provide signed copies of your household's last two years of complete IRS tax returns including Schedule Cs. PLEASE UPLOAD THE ENTIRE TAX DOCUMENTS. (If you do not have a Schedule C, please explain).

2. Letter: Please detail the reasons for financial assistance in 1-2 pages.

3. Documention: The board likes to see official documents supporting the amount requested. These can include, but are not limited to the following:
    a. doctor, hospital, and other related medical or dental expenses.
    b. funeral expenses.
    c. rent/mortgage and utility bills (especially if you are in arrears).
    d. repair bills to your home and/or studio resulting from a disaster.

4. Press: Please include articles from exhibitions, or anything that documents your long time involvement in the visual arts (unless they are included on your website).

5. Resumé or CV: Please include an updated resume which should include your exhibition history, awards, fellowships, permanent collections, etc.

6. Art Work: If you do not have a website with your current work, you will be asked to upload 10 photographs, JPEGs of 2 MB or smaller. Please DO NOT upload images if you have a website.

All candidates please complete the following before going to the next page.

Date:*

MonthDayYear

Legal Name:*

PrefixFirst NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Best number to reach you

Age*

Email*

example@example.com

Check the type of art you practice and for which you receive compensation:*

Number of years you have received income for your artwork:*

Schools Attended (after high school, if any) :

List schools here

If you are a member of any art organizations, please list name(s):

Organizations and clubs separated by comma

Check your marital status:*

Describe the members of your household and their ages:*

Can your children and/or your parents offer assistance? If not, why?

How did you hear about the Fellowship? :*

Friend/FamilyOn-line searchOther ArtistsOther

List your health/medical plan and the limits, if any, of coverage: *

If you do not have insurance please indicate here.

Enrolled in (choose all that apply):*

MedicareMedicaidNoneOther

Are you currently employed, and if so, please describe below:*

Your household's total annual income from all sources (wages, sales, social security, pensions, stocks, bonds, real estate, trust funds, etc.) *

US Dollar Amount

Non-liquid assets (real estate equity, and other):*

Enter 0 if you do not own any assets

Monthly mortgage, maintenance, or rental payment:*

Do you own or rent your home and/or studio (check all that apply):*

Do you have outstanding bills currently? Please list source and amount.*

Please list any other organizations to which you have recently applied for financial assistance:

If you have received grants/awards within the past 12 months, please list the source and amounts here:

Enter sources and amounts separated by comma

Have you ever received financial assistance from the Artists' Fellowship?*

YesNo

If so what year(s) and dollar amount(s):

Enter the years(s)and amount(s)

Financial assistance you are requesting from Artists' Fellowship:*

please put dollar amount i.e. $100.00

A short description of the direct purpose for this amount:*

Please be specific0/300

Signature

1. Signed copies of the household's last two (2) years of complete IRS federal tax returns, including Schedule Cs. (State tax returns are not necessary). PLEASE UPLOAD THE ENTIRE TAX DOCUMENT. If you do not have a Schedule C, please explain in your letter.*

Browse Files

Upload your last 2 entire tax returns including schedule C

2. Your letter detailing the reasons for financial assistance (1-2 pages). Please explain your current financial situation. How are you making ends meet?*

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Letter detailing need

3. Copies of official documents supporting the amount requested. These can include but are not limited to the following: medical or dental expenses, funeral expenses, rent and utility bills (if you are in arrears), repair bills to your home and/or studio resulting from a disaster.*

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Bills and Invoices

3a. Upload any outstanding bills relevant to your request for assistance.

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Bills and Invoices

4. Resumé or CV which should include your exhibition history, awards, fellowships, permanent collections, etc. (Please include materials from exhibitions, articles, or anything that documents your long time involvement in the visual arts.)*

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Resume or CV and other documentation

Your Current Website Address

ex: www.artistwebsite.com

ONLY if you do not maintain a website,
upload 10 images of recent artwork:

( JPGs no larger than 2 MB each)

10 Images of Artwork

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JPGS 2 mb or less

Artists' Fellowship Inc. Financial Assistance Application

Personal Information

Art Background

Family Information

Health Insurance Information

Financial information

Please upload the following: