Artsmemphis FY18 Operating Support Grant Organization Profile & Application

This document is not a grant application. This is a worksheet only. Please submit your grant online https://goo.gl/forms/Oq6AKkrRTOk10qDZ2

ArtsMemphis FY18 Operating Support Grant Organization Profile & Application

IMPORTANT: Use this word document to fill in the requested information so that you may compile your responses. It is not possible to save your work mid- way through completion of the grant application, and it must be filled out in one sitting. Please note that organizations applying for more than one ArtsMemphis grant in FY18 will need to complete the organizational profile information and data one time only - you will not be required to provide this information for other grants due before June 30, 2018 (exception: Arts Build Communities grants).

*Required

Organization Name *

Mailing Address *

City, State *

Zip Code *

Organization Phone Number * Format (xxx) xxx-xxxx

Organization Website *

Grant Contact Name *

Grant Contact Title *

Grant Contact Email *

Grant Contact Phone Number * Format (xxx) xxx-xxxx

CEO/Director's Contact Name *

CEO/Director's Contact Email *

CEO/Director's Contact Phone Number *

Mission Statement *

Vision Statement (if applicable) *

If you do not have a vision statement please enter N/A.

Year Founded/501c3 Established *

What is the first day of your fiscal year? * e.g. July 1st

Most recently completed fiscal year: Actual Revenue Total *

Most recently completed fiscal year: Actual Expense Total *

Current fiscal year: Budgeted Revenue Total *

Current fiscal year: Budgeted Expense Total *

How should your organization be listed in ArtsMemphis publications? *

Do you have a current WheretoGive profile? * Mark only one oval. Yes No

What is your organization's tax identification (EIN) number? *

Demographic Information- Participants

As a requirement of funding from the Tennessee Arts Commission, ArtsMemphis reports on demographic information of all grantees.

"Participant" refers to the estimated total number of individuals directly benefiting from the proposed project. This may include donors, subscribers, members, ticket buyers, audiences, education/outreach/engagement program participants, event attendees, listeners, etc.

Please make sure your numbers are accurate.

Total number of participants, most recently completed fiscal year. *

% of participants under age 18 *

% of participants over age 65 *

% of participants living in rural or isolated settings *

% of participants living with disabilities *

% of participants who are White *

Note: Please be sure that your percentages in this and the following four questions add up to 100%

% of participants who are Black/African American *

% of participants who are Hispanic/Latino *

% of participants who are Asian *

% of participants who are not classified in the above questions *

How do you arrive at the numbers for the above questions? *

For example: biannual visitor evaluation survey, distributed email, observation

In which zip codes are you providing or presenting programming/events in the current fiscal year? Check all that apply. *

This document is not a grant application. This is a worksheet only. Please submit your grant online https://goo.gl/forms/Oq6AKkrRTOk10qDZ2

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This document is not a grant application. This is a worksheet only. Please submit your grant online https://goo.gl/forms/Oq6AKkrRTOk10qDZ2

Demographic Information- Artists Participating

As a requirement of funding from the Tennessee Arts Commission, ArtsMemphis reports on demographic information of all grantees. "Artist" refers to the number of artists directly involved in providing art or artistic services specifically identified with a grant activity; including the number of individual artists of a company, troupe, or touring group.

Please make sure your numbers are accurate.

# of paid artists participating in most recently completed fiscal year programming *

# of unpaid artists participating in most recently completed fiscal year programming *

% of artists who are White *

Note: Please be sure that your percentages in this and the following four questions add up to 100%

% of artists who are Black/African American *

% of artists who are Hispanic/Latino *

% of artists who are Asian *

% of artists who are not classified in the above questions *

How do you arrive at the numbers for the above questions? *

For example: biannual visitor evaluation survey, distributed email, observation

Certifications

By checking the box, this organization certifies that programming will be accessible to all Shelby County citizens regardless of race, color, sex, religion, age, national origin, marital status, sexual orientation, disability or any characteristic protected by law. *

Mark only one oval.

Yes, this organization adheres to the Title VI of the Civil Rights Act of 1964

Request Amount

Enter the amount of your request for FY18.

Narrative Information

Please refer to the Criteria for Evaluation for guidance in completing this section. Provide clear and concise responses to address the criteria as much as possible within the word count limit. Please do not repeat information between questions.

Note that you are not required to write up to the word count limit, rather, you are encouraged to provide your responses as concisely as possible.

Please outline your accomplishments of the most recently completed fiscal year against your stated goals and address any challenges you experienced. (500 word limit) *

Please briefly describe your current fiscal year goals, any challenges you anticipate in achieving these goals, and if and how evaluation was used in developing these goals. (500 word limit) *

Please briefly describe your artistic and administrative capacity to carry out your goals noted above. (350 word limit)

What is your value proposition? Why is your organization unique and important to Memphis? Please briefly describe any efforts in advancing inclusion in the content of your programs and/or the audiences you serve. Please describe any current or developing partnerships or collaborations related to these efforts if applicable. (500 word limit) *

Please briefly describe your board's involvement in and support of the organization. (350 word limit) *

Attachments & Actions Check List

Items noted below as an Attachment are required. Please email the required documents in one message to Tracy Lauritzen Wright at by the deadline on Tuesday, October 17, 2017 at 5:00 p.m. Please be sure to complete any actions noted below by the deadline noted. (FY=Fiscal year)

Check all that apply.

1 Action: WHEREtoGIVEmidsouth.org profile created or updated by 10.6.2017 deadline.

1 Attachment: Financial Appendix (use the template provided)

1 Optional: Attach a narrative clarifying the financial appendix.

1 Attachment: Balance Sheet for recently completed FY, or as of 8.31.2017 if FY17 has not ended.

1 Attachment: List of top 25 donors for last FY, name, amount, note if restricted for specific purpose.

1 Attachment: Staff list, include name, title and tenure.

1 Optional: Bring 2 pieces of collateral materials (annual report, season brochure) to review meeting.

1 Action: Ensure all appropriate staff are signed up to receive announcements from ArtsMemphis, use this link: http://www.artsmemphis.org/contact/