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* 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.

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* 2. This contract constitutes the agreement between Gaston Arts Council and the Artist (complete information below)

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* 3. Amount of Grant Request:

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* 4. Applying for (check only one)

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* 5. Attach A Current Completed and Signed W-9 (page 1 only)

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* 6. Attach Workshop/Training Invoice or List of Materials/Supplies/Equipment and Costs

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* 7. Briefly explain how receiving this funding will help/enhance your artistic endeavors

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* 8. Application Completed by

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* 9. Date

Date

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* 10. Any additional information

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