Grassroots Grant Final Report Form

Grassroots Subgrant Data Collection

Organizations who apply for and receive funding from the NCArts Grassroots Grants Funds, are required to fill out an end of grant report. Failure to submit a report, could prevent eligibility to apply in future years.
Organization Information
Organization Name*
Sponsor/Fiscal Host Organization
If Applicable- If you have a 501c3 as a fiscal agent, please list here
Contact Name*

First NameLast Name
Contact Person's Title *
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Website*
EIN Number*
Organization or Fiscal Sponsor #
UEI Number - If applicable
Organization or Sponsor #
Applicant Race
Project Narrative
Project Name *
Project Narrative *

Please provide a brief description of the project(s) funded: Limit 25 words per project 0/25
Did 50% or more of this project's activities involve arts education; increasing knowledge and skills in the arts to grades Pre-K - 12?*
Did 50% or more of the of the awarded support multicultural artists and/or organizations. *
Total Project Budget

Grassroots Arts Programs subgrants require a 1:1 match. Please include all the funds required to complete the project.
Grassroots Grant Amount*
Matching funds(required)*
Total project budget*

Please list your multicultural artists and/or organizations that were supported with Grassroots funds and the amounts spent for each. In the first column indicate race using the letters A-Asian, B-Black/African American, H-Hispanic/Latino, N-American Indian, and P-Native Hawaiian/Pacific Islander, AND the Name of the artist or organization/business.

	Grant Funding Used	Matching Funds Used
Staff - Administrative
Staff - Artistic
Staff Technical Production
Artistic Contracts
Other Contracts
Space Rentals
Travel
Marketing
Remaining Project Expenses

Participation and Audience Statistics
Total number of adults engaged in person:*
Total number of youth engaged in person:*
How many artists were directly involved?*
Excluding artists, what percentage of project participants were (should add up to 100%)
American Indian / Alaskan Native
Native Hawaiian / Pacific Islander
Black / African-American
Hispanic / Latino
White, not Hispanic
Asian
Select all races/ethnicities that make up the population, 25% or more, that benefit from the award.

Black / African-AmericanHispanic / LatinoWhite, not HispanicAsianAmerican Indian / Alaskan NativeAmerican Indian / Alaskan Native
Select all age ranges that make up the population, 25% or more, that benefit from the award. (required)

Children/Youth (0-18 years)Young Adults (19-24 years)Adults (25-64 years)Older Adults (65+ years)No single age group listed above made up more than 25% of the population directly benefited
Select all distinct groups that make up the population, 25% or more, that benefit from the award. (required)

Individuals with DisabilitiesIndividuals in InstitutionsIndividuals below the Poverty LineIndividuals with Limited English ProficiencyNo single age group listed above made up more than 25% of the population directly benefitedMilitary Veterans/Active Duty PersonnelYouth at RiskNo single distinct group listed above made up more than 25% of the population directly benefited
What percentage of artists in the funded project were (should add up to 100%)
American Indian / Alaskan Native
Native Hawaiian / Pacific Islander
Black / African-American
Hispanic / Latino
White, not Hispanic
Asian
Sub-grant History
Has your organization ever received a Grassroots Arts Program subgrant before July 2023?*
What type of organization are you?*
Support Materials

Please submit materials to support the work you completed with this grant.
Attach any materials used for project publicity and any other printed materials using the North Carolina Arts Council credit line and logo. Attach articles, reviews, and other materials documenting funded project.*

(Flyers with logos, News Releases with NC Arts mention, etc.
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Attach a few images from the completed project(s). We may use this to thank legislators or promote the grant. Please include the name of the photographer in the title of the upload document if they need to be mentioned in credits. *

(Flyers with logos, News Releases with NC Arts mention, etc.
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Attach copies of the letters and/or emails you sent to your State legislators notifying them of the project and your appreciation of this grant. 

(Flyers with logos, News Releases with NC Arts mention, etc.
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Attach a list that includes the names, email or addresses, and art forms of artists and arts organizations participating in your funded project. We use this information to invite them to be registered in our database.*

(Flyers with logos, News Releases with NC Arts mention, etc.
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If you would like to share any links to videos, news articles, or websites that showcase this grant, provide the website URLs here (list link 1, link 2, link 3):
Upload any other important supportive documentation related to your grant that you wish to share with us.

(Flyers with logos, News Releases with NC Arts mention, etc.
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submit the list of artists by uploading a spread sheet or fill in the table below.

REQUIRED! - Artists name, their racial indicator, phone, email, role/medium, and amount paid
Data of Artists and Art Groups who participated
Total Project Budget

	Artist Name	Art Type	Emails
1
2
3
4
5
6
7
8
9
10
11
12

Participant Statistics - Total number of each
Project Start Date

MonthDayYear
Date
Project End Date

MonthDayYear
Date
Should be Empty:

Grassroots Subgrant Data Collection

Organization Information

Project Narrative

Total Project Budget

Participation and Audience Statistics

Sub-grant History

Support Materials

submit the list of artists by uploading a spread sheet or fill in the table below.