Application for an
Arts/Historical Preservation Project Grant
To The City of Wichita Falls
Arts Commission

1.1

Applicant Organization
(Type in text form field):

Mailing Address:

Wichita Falls, TX 76

Telephone:

E-mail:

1.2

Funds Requested (not to exceed $12,500):

1.3

Contact Names:

Title:

Telephone:

E-mail of Contacts:

Is this a new program or continuing program?

New Program

Continuing Program

1.4

How will the requested funds be utilized? (Type in the text box)

1.5

The number of people who attended your programs/activities for the last three years.

2007

Total # of Visitors:

# of Out of Town Visitors:

2008

Total # of Visitors:

# of Out of Town Visitors:

2009

Total # of Visitors:

# of Out of Town Visitors:

2.1

Of your organization's total revenue, how much came from:

Actual figures of completed Fiscal Year Ending

Earned Income

2007 $

2008 $

2009 $

Including fees and memberships

Grants and Donations

2007 $

2008 $

2009 $

Individuals
(Excluding board members)

Board Members

Businesses

Foundations

Endowments

Fund-raising Projects

All Other Revenue

Total

What was your organization's total expense in the last three completed fiscal years?

2007 $

2008 $

2009 $

When does your fiscal year end?

2.2

Is the above financial information from your most recent professional, annual audit?

Yes

No

3.1

Your Organization is a:

Private (c) Corporation Independent School District

Governmental Entity College/University

Other:

3.2

List Board of Directors and Officers:

What percentage (%) of the Board makes an annual financial contribution to the organization?

3.3

List Paid Personnel/Staff:

3.4

Brief organizational history and description of services:

3.5

What is your organization's mission statement?

3.6

Why do you believe the City Arts Commission should support your organization?