Kent County Arts Council






GRANT APPLICATION
Fiscal Year 2012 (July 1, 2011 to June 30, 2012)

You may print this form for application by mail or make your application online.

Part I: THE ORGANIZATION
Name:
Organization's Name
Address
Phone
Email Address:
Is the organization applying for or receiving funding from any other sources for this project? If so, please list the sources and amounts:
Part II: PROJECT INFORMATION
Name of Project/Event
Date(s) of Project/Event
Is this a new project
expansion of an existing one?
Specific locations where the project will be held
Number of people directly involved
Projected attendance
Check appropriate discipline(s): Visual Arts
Music
Theater
Dance
Literary
New Genre

Briefly explain the proposed project:

State the objective and how it addresses the community's need:

Indicate how the community will actively participate:

Indicate your plans to publicize:

Describe the kind of community support you have for this proposal (i.e. use of volunteers, space, donated supplies, etc.):
{this used to be listed as "in kind" support}
Indicate the target number of participants and appropriate age group:
Timetable (include schedule, duration, number of sessions, etc.)
Neighborhood to be served and site location:
Support Materials Enclosed (Please List)
Part III: PROJECT BUDGET (Total cash income must equal total cash expenditures.)
CASH INCOME
Tickets/Registration/Membership $
Cash Contributions $
Organizational Funds $
Itemize all other sources of cash:
Kent County Arts Council Grant Request $
TOTAL CASH INCOME $
CASH EXPENDITURES
Fees $
Salaries $
Supplies/Materials $
Equipment $
Promotion $
Travel $
Rentals $
Other (itemize) $
TOTAL CASH EXPENDITURES $
I certify that the information and financial figures contained in this application are true and accurate.
Signature:
(Organization's Authorized Official )
Name:
Title:
Address:
Phone:
Date:

Mail the printed form to:
Kent County Arts Council, Inc.
P.O. Box 330
Chestertown, MD 21620
Or