Gaston Arts Council Artist Support Grant Question Title * 1. Guidelines: Applicant must reside in Gaston County. By checking the boxes below indicates that you have read and understand and will comply with all guidelines. The funds must be used for costs directed related to artistic development, for example, a workshop/training or purchase of materials/supplies/equipment related to the artist's specific discipline for work on a Gaston County project or event or program Include the the N.C. Arts Council as well as Gaston Arts Council respective logos in/on all promotion, publicity and printed program; Also give verbal recognition when applicable Include this credit in all promotion, publicity and printed program: This project was supported by the North Carolina Arts Council, a division of the Department of Natural and Cultural Resource I understand the Grant Range is between: $250 - $750 Email Gaston Arts Council (gac@gastonart.org) a Brief Progress Report /Update within 30 days after the monies are spent I understand that the award announcements and any other notifications regarding the panel's decision will be provided via email within 10-15 business days after the grant application deadline I understand that if I am selected as recipient of grant funds the check will be mailed within 3-7 business days after all signed grant documents are received by Gaston Arts Council Question Title * 2. This contract constitutes the agreement between Gaston Arts Council and the Artist (complete information below) Full Name Your Art Discipline(s) Street Adress City State Zip Code Phone Number Email Website (if applicable) EIN # (if applicable) Question Title * 3. Amount of Grant Request: Question Title * 4. Applying for (check only one) Workshop/Training Materials/Supplies/Equipment Question Title * 5. Attach A Current Completed and Signed W-9 (page 1 only) PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Attach A Current Completed and Signed W-9 (page 1 only) Question Title * 6. Attach Workshop/Training Invoice or List of Materials/Supplies/Equipment and Costs PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Attach Workshop/Training Invoice or List of Materials/Supplies/Equipment and Costs Question Title * 7. Briefly explain how receiving this funding will help/enhance your artistic endeavors Question Title * 8. Application Completed by Question Title * 9. Date Date Date Question Title * 10. Any additional information Done