Grant Request Grant Application Grand Bend Art Centre 16 Municipal Drive Grand Bend, ON N0M 1T0 519 238 1155 This is the application form for grants from the Grand Bend Art Centre. Grants are available to individuals and organizations. Grants of up to $5,000 are awarded by the board based on availability of funds and contribution to art in the community. Grant requests with other partner support are preferred. The system will immediately send a copy of your submission to the email address of the person input as contact. We will look at your request and respond within a week. If your request is complete it will be discussed at the next monthly board meeting and you will be advised its status shortly thereafter. If your request is approved you will receive a letter containing conditions: initial payment(if any), subsequent payment (conditions may apply) and if project reports are required. Required fields are marked with an *. Questions please contact us. Applicant: * Individual (Contact Person) Organization NameOrganization Name Contact Person Name: * Position: * Position in Organization Address * Address Address Address City City Province Province Postal Code Postal Code Cell Phone * Or other daytime number Other Phone Contact Person Email * Grant Request Section: Project name: * Project Description: * Total $ Budget for the Project: * Include all funding partner participation, your own money and what you are requesting from us. Format: 1000 not $1,000.49 Project Dates: * Is this an ongoing project or provide start and stop dates. Project Location * Funding Request from the Grand Bend Art Centre: * Amount of money, services(i.e. Art centre bldg), supplies - easels, paint, etc Do you have a funding partner? Funding Partner? Yes Yes & the organization is our Charitable Partner No Funding Partner Name: If more than 1 enter the largest contributor. List any other partners in the Funding Partner Funding field below. Funding Partner Contact Name: Funding Partner Contact's Email: Funding Partner Funding: Provide amount of money and/or services requested/provided. Provide conditions if any. If not yet awarded provide the status of the request. How will you work with other organizations on this project? Additional Information How will this enhance the artistic environment of our community? * How will you measure the success of the project? How will you implement the project? Past experience? Will the Grand Bend Art Centre be recognized? How? Information about your organization: Website/URL Website, Facebook page or link to your report on activities/programs Organization Officers: * List names and email addresses. Minimum: President/Chair, Treasurer and any officer who is in charge of the project. For individuals put your own name. Is your organzation? * Non-profit(not charity) Unincorporated association Charity - provide registration numberCharity - provide registration number List previous Grant Requests; * If none enter "None" Organization description: history, goals, accomplishments: Organization operation: employees, contract services, volunteers? Upload: Project Budget and/or Financial Reports: Drop a file here or click to upload Choose File Maximum file size: 1MB File formats: PDF, docx, ODF, xlsx jpg and png Submit If you are human, leave this field blank.
