All Applications Must Have This Page Completed to Be Considered for Funding

All applications must have this page completed to be considered for funding.

Section A - Project Summary and Check List

Applicant’s Name:
Community: / Amount of funding requested
$
Project Title (25 words or less): / Funding category (check one)
___ Professional Development
___ Creation/Production
___ Presentation
Please use this check list to ensure that your application is complete. Incomplete applications will be disqualified.
___ Section A - Project Summary and Check List
___ Sections B1 or B2 - Individual OR Group Information
___ Section C - Project Schedule
___ Section D - Project Proposal with detailed description on separate page
___ Section E - Background Materials Summary
__ a. Artistic or Group Resume including Individual Bios
__ b. Price quotes or letters of confirmation for professional services
___ Section F - Support Materials
__ a. Examples of your work (minimum of 3, listed on the SECTION F SUPPLEMENT page)
__ b. Letters of Support (minimum of 2)
___ Section G - Project Budget with detailed budget on separate page
___ Section H - Presentation to the Public
___ Section I - Applicants Statement with Signature
Section B1 - Personal Information (individual applicants)
Last name First name / Social insurance number
Mailing address
Community and Province Postal code / Telephone Number (daytime)
Fax Number
Years as NWT resident Ethnic origin (optional) Age (optional) / E-mail Address
Section B2 - Group Information (group or organization applicants)
Name of group or organization / Contact name and position
Mailing address
Community and Province Postal code / Telephone Number (daytime)
Fax Number
Type of organization
_____ Non-profit _____ Aboriginal organization _____ Other / E-mail Address
If you are a registered non-profit organization, please provide your four-digit NWT Societies Registry number. /

______SOC #

______Year of registry

Section C - Project Schedule
How many months/weeks will your project take? / Estimated Start Date ______
Estimated Completion Date ______
Will you be working on your project full-time? ______
Will you also be working, attending school or be otherwise occupied? ______
Section D - Project Proposal (provide a detailed description on a separate page)
On a separate sheet of paper, please outline your project in no more than 750 words. You will be evaluated on how you describe your project and its outcomes. You are required to provide the following information:
a) Artistic purpose or goal of the project: how will this project enhance your ongoing artistic development and/or your career?
b) How do you plan to carry out your project? Please remember to include the following: when/where your work will be viewed, the course/instructors, size and medium used, is your work commissioned and/or marketing details.
c) Community impact: describe the impact that your project will have on the community.
Section E – Background Materials Summary
You must provide the following support materials listed below or you may not be considered for funding.
_____ Artistic resume (individuals or workshop instructors), including Group Background or Members individual Biographies including instructors
_____ Price quotes or letters of confirmation for professional services
_____ Minimum 2 support letters, excluding family or project participants (list under Section F)

Section F – Support Materials

You must submit examples of your work. These may be posters, books, scripts, manuscripts, digital and promotional materials or photographs of your work. Clearly indicate which paragraph or page number you would like the members to begin review.
DO NOT SEND ORIGINAL MATERIALS. SAMPLES WILL NOT BE RETURNED.
List your examples on the SECTION F SUPPLEMENT page provided.
Provide 2 or more letters of support from individuals or organizations (excluding family or project participants). They can be originals, faxes or e-mails. List names below of those who will provide you with these references.
1) ______
2) ______
3) ______
Section G – Project Budget with details of budget on a separate page.
Amount of Funding Requested - NWT Arts Council will fund up to a limit of 80% of total project budget.
REVENUES (List all projected revenues)
REQUESTED FROM NWT ARTS COUNCIL (limit of 80% request of total budget) / $
Federal Funding Requested / $
Other GNWT Funding Requested (name Department or Program) / $
Municipal Funding Requested / $
Fundraising Efforts / $
Applicant’s Resources (in-kind, sweat-equity, etc.) / $
Other Matching Sources (please be specific) / $
$
TOTAL REVENUES / $
EXPENSES (List all projected expenses)
Materials and Supplies (describe these in detail) / $
Facility, studio and equipment rental costs / $
Project research (describe exactly what this will be) / $
Honoraria or artists fees / $
Workshop, Professional Courses or Instruction Fees / $
Shipping / freight costs to transport equipment or artwork / $
Framing costs for art exhibits / $
Travel/Accommodations / $
Production, studio and technical costs / $
Other (please be specific) / $
$
$
TOTAL EXPENSES / $

Section H – Presentation to the Public

NWT Arts Council requires you to give a public display, presentation, installation or exhibition of your completed project. Venues do not have to be confirmed at this stage.
How do you intend to accomplish this? Examples: public exhibits at local school or community hall, art installations, workshop delivery, public presentation events, etc.

Section I - Applicant’s Statement

I agree to acknowledge the financial assistance received from NWT Arts Council in all public presentations of this project and by using the NWT Arts Council logo in advertising and on all promotional materials.
I agree to provide copies of the project results as part of final reporting. These may include CDs or DVDs, mp3s, online links and/or videos, photos of project, digital materials, news clippings or promotional materials.
I hereby certify that the information contained in this application is true and correct to the best of my knowledge and belief, and that I do not have any outstanding commitments from previous projects financed by the NWT Arts Council or the Government of the Northwest Territories.
______
Applicant Signature Date

SECTION F SUPPLEMENT

List of Visual Arts or Crafts Samples Support Materials

Please provide at least at least three (3) and up to five (5) images or samples that will serve to introduce the NWT Arts Council to your work. Remember that it will be evaluated on artistic merit, so make sure that you have good quality support material, such as great high resolution images of your work.

Try to use images that clearly relate to what you’ve written about your practice in the application. You should show your work in its best possible light.

Digital stills and copies of photos or sketches must be numbered and correspond to this list. CD image files must be numbered, titled and correspond to this list. CDs must contain no more than the allowable number of images for the program.

Sample 1

Title: ______

Creation date: ______Dimensions: ______

Artist: ______Producer/Collaborator (if applicable):______