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2. Applicant Information
4. First Name*
5. Last Name*
7. Title*
9. Organization*
11. Address 1*
13. Address 2
15. City*
16. State*
17. Zip*
19. Phone*
20. Email*
22. Website
24. Contact Person
28. Applicant Requirements

30. To apply for an HRC Community Cultural Grant, you must meet the following eligibility and criteria requirements.

32. Applicant is (select one):*

    1. an individual
    2. an incorporated nonprofit entity
    3. a registered 501(c)3 - attach a copy of your 501(c)3 letter and most recent 990 form with this application.
    4. an unincorporated association, business, or group with a nonprofit objective
    5. a public school, library, or other municipal agency
    6. a religious organization or school
33. Attach Files*
35. Terms and Guidelines*

    I have read the full terms and guidelines of the HRC Community Cultural Grant Program.

    1. I Agree
39. Project Information
41. Project Title*
43. Project Date(s)*
45. Project Location(s)*
47. Amount Requested from HRC (maximum $2000)*
49. Projected Number of People Served*

51. PLEASE ANSWER ALL QUESTIONS. Failure to do so will result in your grant being denied.

53. Project Summary*

    Description of who, what, when, where, why the event is important to the Valparaiso community.

55. Who is the target audience for this project?*
57. How will the impact of the project be measured and evaluated?*

    Please describe in detail what measurements will be taken to measure impact of your event.

59. How does the proposed project fit the objectives of the HRC and contribute to the cultural diversity of the Valparaiso community?*
61. What is the proposed project location? Have the necessary permissions been granted for the proposed project location? If not, is there an alternate location available if the proposed location is not available?*
63. Please describe the supervisory personnel for this project and their qualifications and expertise.*
65. Please describe any other individuals/organizations with which you will collaborate for this project. Include who they are and how you are collaborating.*
67. Briefly describe the marketing/advertising plan to reach the community, your timeline for implementation, and target audience for this project.*

    (i.e. Posters will be distributed [date], one month before the event, radio PSAs will be aired daily on [date], one week before the event, etc.) 

71. Project Budget
73. Expenses
75. Stipends or booking fees for outside personnel*
77. Space Rental*
79. Marketing/Promotion*
81. Supplies*
83. Other*
85. TOTAL*
87. Income
89. Donations (This should be your match)*
91. HRC Grant Request*
93. Other Grants*
95. In-Kind*

    Note: In-kind can only cover 25% of your total matching funds.

97. Other*
99. TOTAL*
101. Itemized Explanation*

     Please give an itemized explanation of all of the amounts above, including in-kind amounts and how the matching funds will be raised or obtained. Failure to do so could result in your grant being denied.

105. Deadlines and Reporting Requirements

107. All grant proposals are due no later than noon on April 30 for the current cycle. Grant recipients will be notified by the grant committee in June or December respectively of grant award amounts. Successful applicants will be required to sign a grant agreement prior to disbursement of grant monies; 50% of grant amount shall be paid upon signing, and the remaining 50% shall be paid upon completion of a final project and budget report at the conclusion of the funded project. Successful applicants will be required to display the logo and the credit line, “Funded in part with a Valparaiso HRC Community Cultural Grant and the City of Valparaiso.” Logos will be sent to the contact person upon final approval of grant funding from the HRC Community Cultural Grant Committee. A final grant report and budget will be required, showing audience and impact evaluation and final budget figures, within 60 days of the conclusion of the project. 

109. Signature*

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     
     

     1. I agree
111. Signature*
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113. 1. Receive an email copy of this form.
114. Email address

     This field is not part of the form submission.

115. Submit

* indicates a required field