Arts Work Fund for Organizational Development




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Organization Name
Artistic Discipline
Address
City    Zip  
First Name     Middle Name   Last Name 
Title
Telephone  Email 
Year Incorporated #of paid staff: #of board members:
Has the organization previously received an Arts Work Fund grant?  Yes  No
If you are using a consultant, please list the consultant’s name:     
Fiscal Year Ends           
Current Fiscal Year Organization Budget
Income    $ 
Expenses    $ 
Is the organization currently carrying any debt (loan, accounts payable, lines of credit, etc) : Yes  No
Amount Requested           $ 
Total Project Budget          $ 
Project Type                           
Brief Organization Description
Brief Project Description
Authorizing signatures
(Typing in your name acts as your signature and acknowledges that you have reviewed the
guidelines associated with applying to the Arts Work Fund for a grant.)
Staff Leader
Board Chair
Date (mm/dd/yyyy)
Proposal narrative
Project budget
AWF Illinois CDP report form or detailed organizational
operating budgets for the previous two fiscal years
List of current fiscal year funding commitments
Board of Directors list
IRS 501(c) (3) public charity designation determination letter
Most recent audited financial statement or, for organizations
not required to conduct an audit, the IRS Form 990
Consultant's work plan
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