INSTRUCTIONS: Describe all activities planned for the next year as an EMA Affiliate. Attach extra pages if necessary. Return this form, with a cover letter and support materials to the address below.
APPLICANT
Organization, Group or Project Name: ____________________
Designated Representative (principal contact)
Name:_________________________________________________
Address:_________________________________________________
Telephone: (day)______________(eve)______________
Fax:______________Email:_____________________
PRIMARY PARTICIPANTS
List name(s), address(es), phone number(s) and organizational titles of the primary participants: (please attach resumes)
OTHER PARTICIPANTS
List individual Name(s) & Address(es) of any other(s) who will be contracted for services:
ORGANIZATIONAL INFORMATION
Incorporation date, if any: _______.
Organization located in (city) ______________ since (date)_______.
Organization budget, last complete fiscal year (ending:_______): $_______
INTERNAL REVENUE IDENTIFICATION:
Indicate Employer Identification Number, Social Security Number or enclose IRS determination letter (if applicable)
REGISTRATION AS A CHARITABLE ORGANIZATION in your state.
The applicant ___ has registered (date______) or ___ plans to register by (date) _______
If you do not have plans to register, please explain:
PROJECT TITLE:
PROJECT PERIOD:
Start________________End_____________ (month/day/year)
ACTIVITIES/PROJECT DESCRIPTION
Describe the project, immediate purpose and/or product, including location of activities. Describe your long-range plans.
ARTISTIC QUALITY
Describe the artistic accomplishments of the organization and/or the principal artists engaged in the proposed activities. Attach any reviews. Describe how the project will enhance the existing artistic efforts of the appliant/organization.
MANAGEMENT CAPABILITIES
Describe the administrative credentials of the designated representative and/or project director(s). Cite examples of other projects successfully administered by applicant and these individuals.
PROMOTION PLAN
Describe your plans to promote your activities. What new approaches are you using, if any? What new audiences are you trying to reach, and how are you trying to reach them?
EVALUATION
How will you measure the success of this project (attendance figures, artists employed, increased income, surveys, press reviews)?
PROPOSED FUNDRAISING ACTIVITIES
Indicate the total amount of anticipated funds you plan to raise from each category. Enter Zero(0) if you do not plan to ask for or raise funds from the category.
Grants from Government Agencies, Corporations, Foundations: $_______
Donations from Businesses: $_______
Donations from Individuals: $_______
Briefly describe planned fundraising activities. List name(s) of agencies to which applicant plans to apply. Describe future funding, if project is expected to continue beyond the grant project period. What is your contingency plan, if requested funding is not received?
SUMMARY BUDGET FOR PROJECT ACTIVITIES
If several activities will be undertaken, give combined totals for each category. Support summary budget with more detailed budgets for each activity or event (attach to this application).
INCOME:
Sales: $_______
Grants: $_______
Donations: $_______
In-Kind Services: $_______
Other (specify): $_______
TOTAL INCOME: $_______
EXPENDITURES:
Salaries/Wages: $_______
Equipment: $_______
Supplies: $_______
Facilities Rental: $_______
Administration: $_______
Printing: $_______
Postage: $_______
Other (specify): $_______
TOTAL PROJECT COST: $_______
SIGNATURE:___________________________________
Date:______________
Print Name:__________________________
Application Procedures
Applications should be accompanied by a cover letter summarizing the proposal and supporting materials. These materials might include an audio or video recording, biographies of participants, press releases and reviews, a newsletter, etc.
Applications, which should be directed to Early Music America's Affiliate Coordinator/2366 Eastlake Av. E. #429/Seattle, WA 98102, will be reviewed and voted on by Early Music America's Board of Directors, whose decision is final.
Affiliate status will become effective upon receipt by Early Music America of the signed Letter of Agreement (must be signed by EMA's representatives) accompanied by a check for the required administrative fee as well as by membership applications from those Affiliate participants who are not currently members of Early Music America.