Artists in Schools Extended Residencies

Organisation name:

Project Title:

APPLICATION FOR

2011CREATIVE EDUCATION PARTNERSHIPS

ARTISTS IN SCHOOLS – EXTENDED RESIDENCIES

CLOSING DATE: 5pmMonday 30 August 2010

1. What is this form for?

The attached Application Form is for the 2011Artists in Schools – Extended Residencies program.

2. How to apply

Read the Artists in Schools – Extended Residencies Guidelines before completing this form.

Complete all parts of the Application Form.

3. Further information

Inquiries related to completing this Application Form or the 2011NSW Creative Education Partnerships program should be directed to: Phone: (02) 9228 3605.

4. Where to send your Application Form

Postal address:
Arts NSW
ConnectEd Arts Funding Program
PO Box A226
SYDNEYSOUTH NSW 1235 / Hand delivery address (business hours only):
Arts NSW- Reception
Level 9, St James Centre
111 Elizabeth Street
SYDNEY NSW 2000 / Email address:

Emailed applications must include a signed certification and will only be accepted if sent to the aboveemail address. Each application should be submitted in a separate email identifying the applicant’s name and the program’s title in the subject.

5. When is the application due?

Applicationsmust be received by no later than 5pm Monday 30 August 2010.

Late and/or faxed applications will not be accepted.

/ /

APPLICATION FOR

2011CREATIVE EDUCATION PARTNERSHIP PROGRAM FUNDING

ARTISTS IN SCHOOLS – EXTENDED RESIDENCIES

SUMMARY

Organisation’s full legal name:

2011 amount requested from Arts NSW:

Total estimated cost of the project:

Project title:

Brief description of the project(no more than 50 words):

Estimated start date: / Estimated finish date:

Organisation name:

Project Title:

APPLICATION FOR

2011CREATIVE EDUCATION PARTNERSHIP PROGRAM FUNDING

ARTISTS IN SCHOOLS – EXTENDED RESIDENCIES

To fill in this form, click on the shaded cells to enter data. You can use the tab key to navigate through the form or click on the selected cell to enter data.
Use of application information
A list of successful applications may be published on the Curriculum Support website (Department of Education and Training), the Arts NSW website and the Australia Council website. The funding bodies (the Australia Council, Arts NSW and DET) may also publicise recipients in reports and other publications. You will be required to acknowledge the funding bodies in all your publicity. Images submitted with your application and/or acquittal may be used for promotional purposes.
Data resulting from you application, held in the funding bodies’ systems, may be used for the following purposes: statistical reporting, application assessment, media enquiries, accounting purposes and for contacting you. The details of your application will be public information, however, your personal details will only be accessible by our staff and individuals or organisations who may help us assess or monitor grants.
Your signature on this application means you have read, understood and accepted the use of your information as outlined above and you also agree to giving representatives from the funding bodies access to in-school visits for project reporting and program research purposes including photographic opportunities. Your signature confirms that this is the formal and final submission of your application for assessment by the Panel.
Arts NSW adheres to the Privacy and Personal Information Protection Act 1998.
The provisions of the Government Information (Public Access) Act 2009 (which replaced the Freedom of Information Act 1989) apply to documents in the possession of Arts NSW.

Organisation name:

Project Title:

Part 1: ORGANISATION'SINFORMATION

Organisation’s full legal name:
Trading name, if applicable:
Street address of applicant:
Postal address of applicant (if different from street address):
Organisation email:
Website address:
Local Government Area:
(Refer to the Glossary and Explanatory Notes’ document on the Arts NSW website for detail)

Head of organisation(e.g. Chairperson, President)

Position held in organisation:
Title: / Given name:
Family name:
Phone: / Mobile: / Fax:
Email:

Organisation’s contact person for this project:

Position held in organisation:
Title: / Given name:
Family name:
Phone: / Mobile: / Fax:
Email:

School Details:

Full legal name of School:
Principal title: / Given name:
Family name:
Project coordinator’s title: / Given name:
Family name:
Project coordinator’s position:
Project coordinators’ phone: / Mobile:
School address:
Postal address (if different from street address):
School email:
School Website address:
School Phone:

If the Artists in Schools – Extended Residencies project includes working with more than one school or a cluster of schools, please include all school details.

School Details:

To be eligible your organisation must be legally constituted, please identify which of the following best describes your organisation (documentation supporting your status should be attached to your application, if not previously provided):

Not for profit incorporated body
Local Government Authority / Complete part 7 – Organisational Capacity for the business unit/s relevant to this project only.
Tertiary Education Facility / Complete part 7 – Organisational Capacity for the business unit/s relevant to this project only.
Co-operative or Trust
Other - Please specify:
ABN
Are you registered for GST? / Yes / No
Organisation reports and operates on a: / Calender year / Financial year
Are you applying as an auspicor? / Yes / No
Auspicee name:
Contact person for this project:
Position held in organisation:
Title: / Given name:
Family name:
Phone: / Mobile: / Fax:
Email:
Street address of auspicee:
Postal address of auspicee
(if different from street address):

Part 2: PROJECTSUMMARY

Project title:
Brief description of the project (no more than 50 words):
2011 amount requested from Arts NSW:
These amounts must be the same as in part 4 - Project Budget.
Total estimated cost of the project:
Estimated start date: / Estimated finish date:

Primary project type: (tick one only)

Data is for reporting purposes only. (Refer to the ‘Glossary and Explanatory Notes’ document on the Arts NSW website for detail)

Dance
Music (excluding Opera and Music Theatre)
Opera and Music Theatre
Theatre (excluding Physical Theatre and Circus)
Physical Theatre and Circus / Museum
Design
Visual arts and craft
Literature and History
Multimedia
Other Activities (Please specify)

Primary location for the program: (tick one only)

Data is for reporting purposes only. (Refer to the ‘Glossary and Explanatory Notes’ document on the Arts NSW website for detail)

Central West
CentralCoast
Far West
Hunter / Illawarra
Mid-NorthCoast
Murray
Murrumbidgee
Sydney (excl. Western Sydney) / North Western
Northern
Richmond-Tweed
South Eastern
Western Sydney
Other (please specify)

Part 3: PROJECTINFORMATION

3.1. What does the project involve, including rationale, intended audience and any partnerships? (Please note: questions regarding key personnel, milestones and result indicators are included in 3.3)(No more than ½ page.)

3.2. The School – please provide a very brief description of the school/s involved with this project including enrolments and school aims / philosophy. (No more than 100 words)

Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

3.3.Delivery Plan

Who will deliver the Project?

Name of artist/s / Artist/s current arts practice and any relevantexperience including working with young people or communities / Description of the artist/s role in the school, in the development and production of any collaborative work / Number of days the artist/s will work on the project / Is the engagement of the artist/s confirmed?
No Yes
No Yes
No Yes
Name of school project coordinator (if more than one school involved name the project coordinator for each school) / School project coordinator – position and role in the school / Support mechanisms in place to assist the school project coordinator’s management of the project (e.g. extra time allocation for project coordination, support committee, classroom relief) / Number of days the school project coordinatorwill work on the project

What are the key activities and milestones of the project?

Key activities / Key deliverables/milestones / Date / timeframe
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

What are the key result indicators?

Refer to ‘Artists in Schools – Extended Residencies Guidelines’ for further information on assessment criteria.

Key Result Area / Intended Results / Key Result Indicators / Target
Partnerships
Links to Curriculum
Artistic Excellence
Innovation
Participation
Other
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Provide the estimated additional employment figures that will result from this project.

(Refer to the ‘Glossary and Explanatory Notes’ document on the Arts NSW website for detail)

Additional People Employed / Est. Average Employment Hours for the Project / Average Weeks Employer Per Year / Total
Employees:
Full-time / 0
Part time / 0
Casuals / 0
Other:
Contractors and Consultants / 0
Volunteers / 0
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Part 4: PROJECT BUDGET

6.1What is the estimated income and expenditure for this project? All contingencies should be identified separately.

If your organisation is GST registered the income and expenditure budget should exclude GST. If your organisation is not GST registered your expenditure budget should include GST.

Income / 2011 Budget
Earned Income
Sales (box office, admissions, subscriptions, publications etc)
Other
School Contribution
Sponsorship and Fundraising
Sponsorship - cash
Sponsorship – in-kind
Fundraising and Donations
Other Grants and subsidies / Agency Name / Has funding been confirmed?
Local Government Authorities / Yes No
Yes No
Commonwealth Agencies / Yes No
Yes No
Other State Government Departments
eg Events NSW, Arts Victoria / Yes No
Yes No
Non Government / Yes No
Yes No
Amount sought from Arts NSW excl. GST
TOTAL INCOME (total will update upon print) / $ 0
EXPENDITURE / 2011 Budget
Artist/s Fees, On-Costs
Total Artist/s Fees, On-Costs / $ 0
Project / Production Costs
Total Project /Production Costs / $ 0
Promotion/Marketing and Documentation Costs
Total Promotion/Marketing and Documentation Costs / $ 0
Administration Overheads
Total Administration Overheads / $ 0
TOTAL EXPENDITURE / $ 0
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Part 5: AUDIENCE DEVELOPMENT AND PARTICIPATION

Outline your organisation’s strategies for increasing student participation/enjoyment in arts and cultural activities and the indicators you will use to assess if these have been successful (no more than ½ page).

Part 6: BENEFITS

Briefly describe the intended results from the project. Where possible outline how the project relates to the Creative Education Partnerships outcomes outlined in the guidelines. How does this projectcontribute to one or more of the following benefits (no more than ½ page):

Quality arts learning for students
Inclusive arts projects that promote learning for all students
Engaging and challenging learning experiences that connect the arts to the student’s world
Professional learning for teachers and artists
Opportunities for emerging artists to work with young people

Part 7: ORGANISATIONAL CAPACITY

7.1.What is your organisation’s core business and its aims and objectives (no more than ½ page)?

7.2.What is your organisation’s experience and expertise in working with young people and working in schoolsincluding a brief description of your education program if applicable (no more than ½ page)?

Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

7.3.Who are the members of your governing body/committee as it relates to this project?

Name / Position held on governing body/committee / Relevant Experience (no more than ¼ page per individual)
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

7.4 Financial Information(Please note: 2010 data must be consistent with audited financial statements or your statement of income and expenditure (certified by the Chairperson) where audited accounts are not legally required for your organisation)

2010
(actual) / 2011
(estimated)
Income
Earned Income
Government Grants
- Arts NSW
- Other
Sponsorship and Fundraising
Total Income / $ 0 / $ 0
Expenditure
Salaries/Fees
Program/Production/Exhibition costs
Touring Travel costs
Promotion/Marketing costs
Administration Overheads
Total Expenses / $ 0 / $ 0
Net Surplus/(Deficit) / $ 0 / $ 0
Assets
Current Assets – Cash
Current Assets – Other
Non-current Assets
Total Assets / $ 0 / $ 0
Liabilities
Current Liabilities
Non-current Liabilities
Total Liabilities / $ 0 / $ 0
Working Capital (Current Assets less Current Liabilities) / $ 0 / $ 0
Net Assets (Total Assets less Total Liabilities) / $ 0 / $ 0
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Part 8: SUPPORT MATERIAL

Support material should be kept to a minimum and should be directly relevant to the application.

Support material will not be returned.

Support material must be submitted with your application to Arts NSW by 5pm on 30 August 2011. Any support material received separately will not be considered by the assessment panel.

Printed copies of letters of support, proof of legal status, and an example of a catalogue, journal or magazine may be submitted with a printed application if no other support material is being provided. If other support material is provided it must all be in electronic format.

With the exception of emailed applications, TWO copies of all support material should be provided (one copy attached to each copy of your application).

All other support material is to be supplied in electronic format as follows:

Provide two copies of a single CD, DVD or USB drive clearly marked with the applicant’s name and project title with your printed application. (Do not provide hard copies of this support material.)

Email no more than four attached support material files with your application. The application and all support material should be attached to a single email.

No more than 10MB of electronic support material will be accepted per application. Guidelines for the format and quantity of each type of support material are provided below. Any deviations from these guidelines will not be considered by the assessment panel.

It is your responsibility to ensure that support material is provided in the required format.

Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Please listthesupport material included with this application:

TYPE OF SUPPORT MATERIAL / List material provided
Proof of legal status – Required if not previously supplied or if your details have changed
(Electronic format - .doc/ .jpg / .pdf / .ppt.
Printed pages- only accepted with limited other support material, refer to above)
Up to 5 letters of support
(Electronic format - .doc/ .jpg / .pdf / .ppt.
Printed letters- only accepted with limited other support material, refer to above)
including:school, artistand other funding confirmations, confirmation letters from artists and partner organisations, letters of support or agreement from Indigenous artists and/or communities (refer to the Indigenous Arts Protocol on the Arts NSW website).
Up to 5 pages of written material(Electronic format only - .doc/ .jpg / .pdf / .ppt)
including: extract from a script, artist’s statement, extract from a catalogue, journal or magazine
One example of a printed Catalogue, Journal or Magazine.
(only accepted with a printed application)
Up to 10 still images
(Electronic format only - .jpg / .pdf / .ppt)
including:images, sketches, designs
Up to 5 minutes of a video recording
( .mp4 / .mpg / QuickTime)
Up to 5 minutes of an audio recording
( .mp3)
Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Part 9: Checklist

BEFORE SENDING YOUR APPLICATION

Ensure that you have:

Provided any overdue acquittal reports. Overdue acquittals will prevent payment of any future grants. Any acquittals submitted with your application should be clearly marked as an acquittal.

Provided proof of your legal status, if not previously supplied or if your details have changed.

Completed all questions. Incomplete applications may be deemed ineligible.

Provided support material (if relevant) in accordance with the guidelines and completed the table in part 8.

Signed the application (part 10).

Kept a copy of the application for your records.

Printed Applications

Enclosed ONE original and ONE single-sided copy of your application. The copy will be used for assessment purposes and therefore must contain the entire application, including support material.

Provided only single-sided documents packaged using a removable clip (Do not stapled, bind, or enclosed documents in a folder).

Emailed Applications

Submitted your application in one single email.

Attached a copy of the signed declaration (PDF).

Attached no more than four support material files in the required formats.

Arts NSW – 2011 Creative Education Partnerships / Page 1 of 25
Project Application Form – Artists in Schools – Extended Residencies

Organisation name:

Project Title:

Part 10: Declaration

In signing this document I acknowledge that I:

have read the Artist in Schools – Extended Residencies Guidelines.
certify that, to the best of my knowledge, all the information in this application is correct and has been approved by the Board of Directors or equivalent body and that I have the delegated authority to sign this application.

agree to accept the decision of the panel assessing this application.
have read and understood the section on Privacy and Freedom of Information and accept the terms.
acknowledge that Arts NSW may check with other funding bodies that the information provided in this application is correct.
acknowledge that Arts NSW has the right to withdraw the offer of funding or demand the return of any funds already paid if any of the information supplied is false.
am aware of the NSW Working With Children Check Policy (2005) and will take the necessary steps to submitProhibited Employment Declaration and Consent to Employment Screening forms.