GAP-ARPA-Subgrant-Application-FY23-24.pdf

American Rescue Plan Act Federal Funding
Subgrant Application
FY 2023-2024

Submit this report to your funding agency. It should not be submitted to the North Carolina Arts Council.

I. Organization Information

Name of Organization _________________________________________________________________

Contact Person’s Name________________________________________________________________

Contact Person’s Title _________________________________________________________________

Mailing Address _____________________________ City _____________________________________

State: North Carolina Zip Code _________________ County________________________________

Work Phone (___) ______________________ Fax Number (___) _____________________________

E-mail Address _______________________________________________________________________

Website _____________________________________________________________________________

Organization’s EIN_____________________________________________________________________

Organization’s UEI_____________________________________________________________________

Applicant Race_ Please select one

Please give a brief description of your organization, including mission, board and staff composition, current arts programs and services and number and kinds of people served. Public schools and other large governmental or community agencies should provide a description of their arts program only rather than the entire organization.

Organizational Finances:

Please attach complete income and expense statement (an audit may be substituted) for your last fiscal year and complete operating budgets for the current fiscal year and next fiscal year. Public schools and other large governmental or community agencies should attach arts program financial information only. Please copy the totals from these attachments in the spaces below.

II. Project Description

Grant Amount Requested: __________________

Project Start Date: ________________________

Project End Date: _________________________

Project Narrative:

Please attach a narrative providing the information requested below for the project you propose. Please be concise and specific as possible:

1. Project title or summary description
2. For capacity-building, sustainability, or expanding relationships with diverse artists and arts organizations, please list intended goals/outcomes.
3. Description of intended participants/audience, including estimated numbers and racial and cultural composition
4. Location where project will take place
5. Description of project activities
6. Description of the artists, partners, or consultants to be involved in the project, how and why they were chosen and, if appropriate, the rate of payment for their services (If you have not yet selected the artists, describe the kinds of artists you intend to involve and how you will select them.)
7. Description of how the project will be publicized and promoted to reach intended participants
8. Description of how you will evaluate the project

Project Budget:

Please provide a projected budget for your proposed project utilizing the format below.

Certification

We understand that failure to respond to any of the above items may adversely affect the consideration of this application. We certify that we are committed to the completion of the proposed project in compliance with legal requirements and granting procedures. We certify that the information contained in this application, including attachments and supporting materials, is true and correct to the best of our knowledge.

Name and Position of Authorizing Official ______________________________________________________

Signature of Authorizing Official ________________________________________ Date ________________

Signature of Contact Person ____________________________________________ Date ________________