BCCC Grant Application Form Grant applications are accepted annually from October 1 – October 31. BCCC Grant Application Benton County Cultural Coalition grants are awarded to registered 501(c)(3) art/heritage/cultural organizations located in Benton County, Oregon. If you are not a registered 501(c)(3) you must declare a 501(c)(3) organization as your fiscal non-profit sponsor. Be advised that most organizations charge a small percentage to serve as your fiscal sponsor. This fee should be factored into your project budget and the amount of your grant request. All activities and/or art installations must take place on property that belongs to a Benton County public or 501(c)(3) organization. GRANT APPLICATION INSTRUCTIONS: The Benton County Cultural Coalition seeks to identify art, humanities, and heritage projects that support an active, accessible cultural life throughout Benton County. We look for a well formulated plan of action for implementation. We appreciate innovative grants that either reach the greatest number of Benton County residents or those that will engage a smaller segment of the population, providing outreach and engagement in areas where increased access to programming would be especially beneficial. Complete the on-line Grant Application form found below. Submission deadline is 11:59pm on October 31st. NOTE: Our format requires you to complete the Grant Application form in one sitting: you may want to prepare your answers before you begin. Grant award recipients will be notified by December 5th. Those selected will need to sign a BCCC Grant Agreement by December 15th. Checks will be awarded in early February. If you have any questions, please email us at firstname.lastname@example.org Name of Organization Applying for Grant Funds* Name* First Last Email* Evening Phone*Fiscal Status* My organization is a 501(C)(3) non-profit I am not affiliated with a non-profit and will declare a fiscal non-profit sponsor If you are not affiliated with a non-profit, please provide the name of the organization that has agreed to serve as your fiscal non-profit sponsor. What is the dollar amount of your grant request from BCCC (nearest dollar amount, no commas or dollar signs)* Address*If a Fiscal Non-profit Sponsor will be used, please provide their address. If not, please provide the mailing address for the organization that is applying for grant funds: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Project completion date* What is the title of your project or event?* Where in Benton County will this project or event take place?* Provide a brief description of your project or event. Include project stages if applicable.*What is the objective of your proposed project/event?*Select any of the following benchmarks that you feel will be met by your project or program:* Strengthen organization or individual capacity Preserve or improve historic building or structure Increase participation in or access to culture Lifelong Learning Stories/Oral Traditions Public Art Cultural Tourism Youth Economic Development Project Expenses:How will your grant funds be utilized if selected for funding? (Please enter a number or a 0 for each field as applicable, no commas or cents)Stipends* Cost of Artist or Contractor* Supplies & Materials* Facility Cost or Rental* Overhead cost (Indirect due to non-profit)* Transportation* Other Other: Please ExplainTotalThis is the total dollar amount of your expected expenses. $0.00 Project Revenues: Please detail expected income from all sources (including what you are expecting from the BCCC), such as other grants, cash donations, ticket sales etc:*Please list the total dollar amount of your Revenues, i.e. total of above detail.*(No $ sign, no commas) If Project Expenses differ from Project Revenues, please explainIf you have utilized BCCC funds for a similar project in the past, please explain how this project offers something new or serves a particular niche in the community.Who is your target population and how will Benton County residents benefit?*If your event has an admission price, please list it here (no commas). If the event is free, please list 0 (zero)* If the project involves public art, signage or other construction, briefly describe the required approval process and timeline. What approvals have already been secured?If selected, where will you display/include the BCCC and Oregon Cultural Trust logos to acknowledge your grant funding*Are you a registered Participating Cultural Non-Profit with the Oregon Cultural Trust?* Yes, it was easy! Not yet, but I will visit http://www.culturaltrust.org/get-involved/nonprofits/ and register ASAP! HiddenPlease describe any differences between the information provided in this Grant Application and what was included in your Letter of Intent (LOI). If no difference write "NONE".