ArtsBridge Subsidy Request Application Survey

1. ArtsBridge Subsidy Request Application

The Cobb Energy Performing Arts Centre Foundation provides subsidies for admission and/or transportation to schools with financial challenges. Subsidies are granted based on individual need and available funds. Subsidy Request Applications are evaluated on a first come, first serve basis. It is our goal to serve as many students as possible, however resources are limited.

Please observe the following instructions:
1. Complete, print (for your records), and submit the online ArtsBridge Reservation Form (https://www.surveymonkey.com/s/ArtsBridgeReservation).
2. Complete, print (for your records), and submit the Subsidy Request Application online (i.e. THIS form).
3. The ArtsBridge staff will reply to your request within two business days of receipt.

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1. Please provide the primary contact information for your reservation:

Please provide the primary contact information for your reservation: Name:
School/Group:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

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2. Describe your school:

Describe your school: After School Program

Homeschool

Public School

Public School, Title 1

Other (please specify)

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3. Please provide your school/group ethnicity population demographics. Provide a percentage for each of the following categories (percentages should total 100%):

Please provide your school/group ethnicity population demographics. Provide a percentage for each of the following categories (percentages should total 100%): Asian
Black
White
Latino/Hispanic
Other

4. For information about the 2011-12 ArtsBridge season visit cobbenergycentre.com/education. Please select your school group reservation(s) (select all that apply):

For information about the 2011-12 ArtsBridge season visit cobbenergycentre.com/education. Please select your school group reservation(s) (select all that apply): Kennedy Center Theater for Young Audiences on Tour, Locomotion-$8 (1/11 @ 10 am)

Quincy Jones Presents-Alfredo Rodriguez Trio-$8 (1/13 @ 11 am)

Gas South Broadway Series, Blast!-$8 (1/20 @ 11 am)

Georgia Shakespeare, A Midsummer Night's Dream-$7 (2/2 @ 11 am)

Georgia Shakespeare, A Midsummer Night's Dream-$7 (2/2 @ 4 pm)

Atlanta Ballet, Snow White-$7 (2/16 @ 11 am)

Georgia Ballet, Dance Through the Ages-$5 (5/9 @11 am)

ArtsBridge subsidies are provided by generous and limited contributions. We ask you to partner with us to help make your field trip possible. Please request subsidies for the portion of the expense your school cannot cover. This will allow us to serve more schools who also need this important assistance.

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5. ADMISSION SUBSIDIES
Please provide more detail about your admission subsidy needs.

ADMISSION SUBSIDIES Please provide more detail about your admission subsidy needs. How many people will attend each performance (total: students & chaperones)?
What is your field trip budget (annual and/or per trip)?

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6. TRANSPORTATION (BUS) SUBSIDIES
ArtsBridge provides transportation assistance through limited contributions. BUS SUBSIDY MUST BE REQUESTED PRIOR TO YOUR FIELD TRIP AND WILL NOT BE GRANTED POST-TRIP.

TRANSPORTATION (BUS) SUBSIDIES ArtsBridge provides transportation assistance through limited contributions. BUS SUBSIDY MUST BE REQUESTED PRIOR TO YOUR FIELD TRIP AND WILL NOT BE GRANTED POST-TRIP. What is your transportation (bus) budget (annual and/or per performance)?
What is the cost for one bus and driver per field trip?
How many buses do you need subsidy assistance with per field trip?

TRANSPORTATION NOTICE
If you are selected to receive transportation subsidy support, ArtsBridge must receive an invoice from the district transportation vendor and cannot reimburse schools or individuals directly. Schools that order subsidy-funded buses without prior approval and/or pay for them first, will not be able to receive ArtsBridge subsidy support. Follow these three steps when ordering your field trip transportation:

Step 1: Receive subsidy approval from ArtsBridge.

Step 2: Place your school bus order with your district transportation office.

Step 3: Notify your transportation office to invoice the Cobb Energy Performing Arts Centre Foundation.

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7. Subsidy funding is provided for public schools that have no other resources for funding field trip participation. Please help us assist other schools in need by leveraging every dollar possible from your school community. Please note that subsidies are subject to availability and may be revoked if a recipient misrepresents financial need and/or violates ArtsBrigde or the Cobb Energy Performing Arts Centre Foundation policy.

Subsidy funding is provided for public schools that have no other resources for funding field trip participation. Please help us assist other schools in need by leveraging every dollar possible from your school community. Please note that subsidies are subject to availability and may be revoked if a recipient misrepresents financial need and/or violates ArtsBrigde or the Cobb Energy Performing Arts Centre Foundation policy. I understand subsidies are based on true financial need and confirm my school's financial need and desire to participate in ArtsBridge.

I do not understand the ArtsBridge subsidy program.

Please explain:

Thank you for interest in ArtsBridge. Your Subsidy Request Application will be evaluated and processed with your Reservation Request Form. For questions contact: education@cobbenergycentre.com.

ArtsBridge Subsidy Request Application

1. ArtsBridge Subsidy Request Application

*1. Please provide the primary contact information for your reservation:

*2. Describe your school:

*3. Please provide your school/group ethnicity population demographics. Provide a percentage for each of the following categories (percentages should total 100%):