Artists' Fellowship Inc. Financial Assistance Application

NOTE: The Artists' Fellowship provides limited financial aid to visual artists and their families in times of emergency caused by sickness, disability, natural disaster, or bereavement. Assistance is given without expectation of repayment. We do not provide grants or fellowships: requests for funding to support study, travel or exhibitions, or to purchase art supplies, will be denied. 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. Kindly label all documents, e.g. "bill_credit_card.pdf" "studio_lease.pdf," etc.

1. Letter: In 1 or 2 pages, please explain the nature of your emergency (e.g., lost income or incurred debt due to sickness, disability, natural disaster, or bereavement) and describe how you would use the financial aid you have requested.

2. 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).

3. Documentation: Please provide documentation about your emergency situation. This can include, but is not limited to the following:

doctor, hospital, medical or dental bills.
bill for funeral expenses.
rent/mortgage and utility bills (especially if you are in arrears).
repair bills to your home and/or studio resulting from a disaster.
images of damage caused by disaster (e.g., fire or flood).

4. Resumé or CV: Please include an updated resume showing your exhibition history, awards, fellowships, permanent collections, etc.

6. Art Work: If you DO NOT have a website with your current work, upload 10 images, JPEGs of 2 MB or smaller. Please don't upload images if you have a website.

5. Press: If not on your website, please include articles from exhibitions, or anything that documents your long time involvement in the visual arts.

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

Health Insurance: 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

If your property was damaged, do you have homeowners/renters or car insurance that will cover some of the costs?

List terms of home/renter/car insurance information

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

Your adjusted gross income as reported on your last tax return (line 11 of Form 1040)*

US Dollar Amount

Your household's total annual income from all sources (wages, sales, social security, pensions, stocks, bonds, real estate, trust funds, etc.), if this is different from your Adjusted Gross Income.

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 applied for financial assistance from the Artists' Fellowship?*

YesNo

If yes, when did you apply, and what was the outcome?

Enter the years(s) and amount, if applicable

The Artists' Fellowship provides limited financial aid to visual artists and their families in times of emergency. Please briefly summarize the nature of your emergency (for example: lost income or debt incurred due to sickness, disability, natural disaster, or bereavement).*

Please be specific0/300

Financial assistance you are requesting from Artists' Fellowship:*

please put dollar amount i.e. $100.00

Describe how you would use the financial aid requested, providing dollar amounts for individual items so that they add up to the total amount requested. *

How aid would be used0/300

Signature

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

Browse Files

Letter detailing need

2. A signed copy of your most current IRS federal tax return, including Schedule C. Please upload the entire tax document. State tax returns are not necessary. If you do not have a Schedule C, please explain in your letter.*

Browse Files

Most current federal tax return

3. A signed copy of your previous year IRS federal tax return, including Schedule C. *

Browse Files

Previous year federal tax return

4. 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. Please label accordingly.*

Browse Files

Bills and Invoices

5. Any documentation that would help us understand your emergency (for example, a doctor's note, or photos of property damage) if this is not already clear from the other documents you have provided.

Browse Files

Bills and Invoices

6. 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.)*

Browse Files

Resume or CV and other documentation

7. An image of a current driver's license, passport, or other form of official ID. Please label accordingly, e.g. "John Doe license":*

Browse Files

ID

Do you have a website?*

YesNo

Please provide your current website address*

ex: www.artistwebsite.com

Please upload 10 images of recent artwork. (JPGs no larger than 2 MB each)*

Browse Files

JPGS 2 mb or less

Artists' Fellowship Inc. Financial Assistance Application

Personal Information

Art Background

Family Information

Insurance Information

Financial information

Please upload the following: