Category of the grant being applied for.(Required) Applicant's Name(Required)
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Artistic Discipline of the Project(Required) Dance Music Opera/Music Theater Theater Theater- Storytelling Visual Arts Design Arts Crafts Photography Media Arts Literature Interdisciplinary Folk-Traditional Arts Humanities Multi-Disciplinary Non-Arts/Non-Humanities
What artistic activities will occur?(Required)
What are the Project goals?(Required)
Why is this Project needed in Delaware County?(Required)
Who do you hope to reach? Who is your target audience?
Composition of audience. No Single Group Native American/Alaskan Asian Black/Afircan American Hawaiian/PAcific Islander Hispanic/Latino White, non-hispanic
How will this award help you to better your career or provide access to tools and professional development?(Required)
How will you cope with unexpected changes that might occur, such as less funding, change in personnel, rainy weather?(Required)
How will you let people know about this Project?(Required) How do you plan to publicize your project? Make sure any measures that require funding are also budgeted.
Is the Project site accessible? Is this site accessible to people with disabilities? Are there steps up to the entry, doorways wide enough for wheelchairs, and accessible bathrooms? If not what measures will you take to make sure it is as accessible as possible? E.g. I will have a member of staff on the door to greet and assist people getting up the stairs.
E.g. I will have a member of staff on the door to great and assist people getting up the stairs.
Provide more detail about your projects dates, locations, concert series, workshops dates, exhibitions etc For example; The Roxbury Arts Group will host 6 concerts at the local Farmers Market through July and August. Concert 1. **/**/**** at 6 pm, Performer name, brief description about the performer and their music at the performance venue. (Repeat for all dates) Or the Roxbury Arts Group will work with artists ****, ****, ****, and lead 3 instructional dance classes resulting in a final performance in Kirkside Park on **/**/**** at 6 pm. Workshop 1. **/**/**** at 6pm, workshop topic and brief description about class, location of class. (Repeat for all events). While not a requirement, stronger applications have set dates at the time of application. Be as specific as possible at the time of application. If you do not have set dates include a targeted time frame (for example a month or season such as in the fall) and follow up with the Roxbury Arts Group once dates are set.
What measures will you use to evaluate the success of your Project?(Required)
Resume and work samples of admin and artistic personal.(Required) Upload, work samples, resumes, biographies etc to show how the staff and artists are qualified to execute this project. You may upload up to 10 documents in these formats doc, docx, pdf, gif, jpg, png. Files are restricted to 32MB in size.
Budget(Required) Applicants MUST use the budget templates provided.
Grant award requested(Required) This is the total amount you are requesting from the Delaware County Arts Grant. THIS NUMBER MUST MATCH YOUR BUDGET. IF NOT THE LOWEST REQUESTED NUMBER IS CONSIDERED. Make sure you meet the minimum and maximum funding limits. For more information see this year’s current Delaware County Arts Grant guidelines.
What specifically will you use Delaware County Arts Grants funds to pay for?(Required) Ensure all expenditures meet eligibility requirements by referring to the current year’s Delaware County Arts Grant guidelines.
What are the participation fees, fees to attend, and discounts (if any) provided?
Has yourself, the artists involved in your project, fiscal sponsor or organization applied directly to NYSCA no matter if this was successful?(Required) Have you or your organization received a Delaware County Arts Grant or Decentralization Grant in the last 3 years?(Required) Key Administrative Person (Name)(Required) This will be the Roxbury Arts Groups first point of contact for your project. This may be the same info as the applicant person.
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Key Artistic Personnel(Required) This may be an artist, musician or agent.
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How are the key personnel qualified to execute this Project?(Required)
Under what conditions are you applying?(Required) W9(Required) All applicants must upload a W9. W9 must be dated in the current year. Applicants that are non-profits applying directly or those Fiscally Sponsored must include their non-profit EIN. Organizations and artists applying through the Roxbury Arts Group Fiscal Sponsorship program must complete the W9 with a designated Social Security number. Organizations should identify who this individual is in their Letter or Authority.
Proof of Delaware County Residency.
Type of Organization Performing Group Performing Group- College/University Performing Group- Community Performing Group- Youth Performance Facility Art Museum Museum- Other Gallery/Exhibition Space Cinema Independent Press Literary Press Fair/Festival Arts Center Arts Council/Arts Agency Arts Service Agency Union/Professional Association Parent/Teacher Association Elementary School Middle School High School Vocational/Technical School Other School College/University Library Historical Society/Commission Humanities Council Foundation Corporation Community Service Organization Correctional Institution Health Care Facility Religious Organization Senior Citizens' Center Parks/Recreation Government Media-Newspaper, Radio, Television, etc. Cultural Series Organization School of the Arts Social Service Organization Child Care Provider None of the Above
Artistic Discipline of Organization Dance Music Opera/Music Theater Theater Theater- Storytelling Visual Arts Design Arts Crafts Photography Media Arts Literature Interdisciplinary Folk-Traditional Arts Humanities Multi-Disciplinary Non-Arts/Non-Humanities
Organization Contact Name
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Organization Address
Status of Non-Profit Organization NP Dept of Edu NP Dept of State Unit of Government/Native American Tribe Other
Composition of Organization No Single Group Native American/Alaskan Asian Black/African-American Hawaiian/Pacific Islander Hispanic/Latino White, non-hispanic
Upload a Mission Statement
List of board members (with addresses)
Financial Statement for last completed fiscal year. This could be a Treasurer's Report or a copy of the IRS 990 Form. Blank Statements will not be accepted.
Proof of non-profit status. 1. IRS tax-exempt letter 501(c)(3) 2. Letter from NYS Board of Regents Charter, section 216 of the Education Law 3. Current NYS Bureau of Charities (Office of the Attorney General) Filing receipt 4. Letter of Incorporation under section 402, Not-for_Profit Law 5. Letter from local government. NOTE: A NYS Tax Exempt Certificate from Dept of Taxation and Finance is NOT considered proof of non-profit status.
Letter of Authority If you are applying on behalf of an organization you need to upload a letter of authority showing you have permission to apply. This letter should; be on the organization’s letterhead, be signed by at least one other board member, be dated in the current year, detail you have permission to apply
Letter of Responsibility for Permanent Equipment If you intend to purchase permanent equipment you must upload a letter outlining who will become responsible for the equipment after the end of the grant period. This must be signed by the non-profit board president.
Letter of Agreement If you are working with a Fiscal Sponsor, Community Partner or the Roxbury Arts Group you should upload a letter of agreement between you and the organization. This letter should detail that you have permission to apply, be dated in the current year, be signed by a member of the non-profits board or organization and detail agreed roles and responsibilities between you/your organization and your Fiscal Sponsor/Community Partner/RAG. If you are an organization or business with no 501c3 status, or are being sponsored by the Roxbury Arts Group, your letter should detail what individual will be receiving the award (funds cannot be paid out to a business, this individual needs to match the W9 provided with your application).
Does your project take place in or after school in a public school setting? Or does it take place in another learning environment? Contact name at school
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School Contact Mailing Address
Letter of Commitment A letter of commitment between the artist or organization working with the school must be included for in and after-school projects. The letter should be on the organization’s letterhead (if applicable) and be signed by both the artist and organization and the Principle of the partnering public school. The letter should include in detail the artistic activities that will occur and the roles and expectations of the artist, organization, and school, agreed on by all parties.
Please select which, if any, type of art education applies to your project: NYSCA Reporting Requirement
None Less than 50% K-12 Less than 50% Higher Ed Less than 50% Pre-K Less than 50% Adult Learners (including teachers and artists) More than 50% K-12 More than 50% Higher Ed More then 50% Pre-K More than 50% Adult Learners (including teachers and artists)
Please select which, if any, of these descriptors apply to your project: NYSCA Reporting Requirement
Accessibility International Presenting/Touring Technology Youth at Risk None of the above
NYS Senate District NYSCA Reporting Requirement
42- Delhi, Colchester, Hamden, Masonville, Tompkins, & Walton 51- Andes, Bovina, Davenport, Franklin, Harpersfield, Kortright, Meredith, Middletown, Roxbury, Sidney, & Stamford 52- Deposit & Hancock
NYS Assembly District NYSCA Reporting Requirement
101- Andes, Bovina, Davenport, Delhi, Hamden, and Meredith 102- Harpersfield, Kortright, Middletown, Stamford, and Roxbury 122- Colchester, Deposit, Franklin, Hancock, Masonville, Sidney, Tompkins, and Walton
Guidelines and information session.(Required) I (the applicant) or a representative of my organization have attended at least one information session either in a group session or with a one-on-one with the Grants and Community Coordinator and read this year’s guidelines.
Name of the person who attended(Required)
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I understand applicants must be 18 years of age or older.(Required) Acknowledgment(Required) Final Reports are due 30 days after the last date of your project or before December 31st of the project year. If your project is Fiscally Sponsored, final reports must be signed by a member of the Fiscal Sponsors board. Templates are available.
Project changes(Required) The Roxbury Arts Group must be kept aware of changes to your project through a Change of Scope. It is expected that applicants keep Fiscal Sponsors aware of any changes if Change of Scopes are not submitted directly by them. If you have had to make changes to your project due to partial funding a Change of Scope is required. Templates are available.
Consent(Required) The undersigned certifies that he/she (1) is an authorized signatory on behalf of the organization; (2) has knowledge of the information presented herein; (3) has read and understood the guidelines of the Roxbury Arts Group Community Arts Grant Program and complies with and is made subject to said guidelines; (4) releases RAG, its employees and agents with respect to damages to property or materials submitted with this application and (5) that this applicant is not currently under consideration for NYSCA funding.
I (the applicant) agree to the certification detailed above
