Arts & Humanities Grant Application Form

Organizational information

1. Project Title:

2. Applicant organization name:

3. Applicant organization address:

4. Applicant organization primary contact:

5. Primary contact job title:

6. Primary contact email:

7. Primary contact phone:

8. Is the primary contact also serving as the Project Director?

If not:

8a. Project Director name:

8b. Project Director email:

8c. Project Director phone:

8d. Project Director mailing address:

9. If your organization has received MHC and/or MAC funding in the past three years, please list the project name(s) and amount(s) awarded.

10. Is your organization a 501c3 organization, a government organization (such as a federally recognized Indian tribal government or organization or state/local/city government), a church, or an education organization (school or school district, public or private institution of higher education)? YES OR NO

If not, you will need an organization of that type to serve as a fiscal sponsor. For more information, please visit the Maine Community Foundation’s page on fiscal sponsorship:

10a. Fiscal sponsor organization's name:

10b. Fiscal sponsor organization's primary contact:

10c. Fiscal sponsor organization's address:

10d. Fiscal sponsor organization's phone:

10e. Fiscal sponsor organization's primary contact email:

Certification

11. Authorizing official:

12. Authorizing official title:

This should be the person from the applicant organization who is authorized to submit this application for funding (such as the executive director) and who will agree to comply with the certifications below.

_____By checking this box, I certify that I will make all reasonable efforts to comply with the following federal nondiscrimination and eligibility provisions.

Because a portion of Maine Humanities Council and/or Maine Arts Commission grant funds may originate with the Federal government, applicants must certify that they will make all reasonable efforts to comply with the following federal nondiscrimination and ineligibility provisions: 1. Certification Regarding Nondiscrimination (a). Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), which provides that no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant received federal financial assistance; (b). Section 504 of the Rehabilitation Act of 1973. As amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicap in programs and activities receiving federal financial assistance; (c). Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681 et seq.), which prohibits discrimination on the basis of sex in education programs and activities receiving federal financial assistance; and (d). the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101 et seq.), which prohibits discrimination on the basis of age in programs and activities receiving federal financial assistance, except that actions which reasonably take age into account as a factor necessary for the normal operation or achievement of any statutory objective of the project or activity shall not violate this statute. 2. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (a). The applicant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (b). Where the applicant is unable to certify to any of the statements in the certification, such prospective participant shall attach an explanation to this proposal.

Project description

13. Brief project abstract

14. Project start and end date

15. Project activities

Please list the following information for each proposed event or activity associated with your project. If there will be more than one, please list each separately.

  1. Type of event (lecture, exhibit, performance, discussion group, etc.)
  2. Date
  3. Time
  4. Location
  5. Estimated audience number
  6. The Congressional district in which the event or activity will take place

16. Will a fee be charged?If yes, please explain fee(s).

17. Provide a detailed description of the project. (Is it an event, an exhibit, a panel discussion? What is the central component of the project?).

Explain your project and all associated activities or events in more detail. Some things to include: what is the history of your project? What subject, ideas, and questions will your project explore, and why are they important, timely, and interesting? How will the contributions of participating humanities or arts professionals shape the project? If the project can serve as a model, how can it be replicated? Will there by more activity beyond the grant period?

18. Describe both the arts and the humanities elements of the project. What public programs are planned as part of the initiative?

19. Who will carry out the project? Please name the key personnel and organizational partners.

20. How will the project be publicized to ensure the broadest community involvement and exposure?

21. What will be the end product/goal of this project and when will it be completed? (Applicants may create a time-line.) Describe plans for evaluating the project.

22. Why is this project important to the organization, co-sponsors (if any), and community? How will the success of the project be assessed?

Supporting documentation

We also ask that you email supporting documentation (not all may apply): CVs, resumes, or bios for consultants; letters of support; estimates; exhibit maps; etc. to .

Budget

Please fill out the accompanying Excel Budget Form and email it together with this application and any other supporting documentation to .

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MHC and MAC Arts & Humanities Grant Application