Fillable LCC PROGRAM: STANDARD GRANT APPLICATION (City of Worcester)

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LCC PROGRAM: STANDARD GRANT APPLICATION (City of Worcester)

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The LCC PROGRAM: STANDARD GRANT APPLICATION (City of Worcester) form is 4 pages long and contains:

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  • 17 check-boxes
  • 65 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Worcester

BROWSE CITY OF WORCESTER (MA) FORMS

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Application Number (for LCC use only) __________________
LCC PROGRAM: STANDARD GRANT APPLICATION
This application is being submitted to the LCC.
Please type into the form, print, sign and mail it to the appropriate Local Cultural Council. E-mailed applications will not be accepted.
Click on the underlined blue words to access the Glossary. Important: Use the ‘TAB’ key to move through the application.
APPLICANT INFORMATION
Name:
Address:
City, State, Zip:
Phone: Email:
Website:
Contact Person (if different than applicant):
Address:
City, State, Zip:
Phone: Email:
APPLICANT REQUIREMENTS
To apply for an LCC grant you must meet ALL of the following eligibility and criteria requirements. Please attest that each
statement is true by checking the box next to the statement:
I have read and understood any local guidelines and criteria that this Local Cultural Council has posted at
https://www.mass-culture.org/lcc_public.aspx.
The applicant is (select one):
an individual
an incorporated nonprofit
an unincorporated association or group of people with a nonprofit objective
a public school, library, or other municipal agency
a religious organization or school requesting funds for cultural programming that does not have the effect of advancing
religion
The applicant resides in or is located in Massachusetts.
The applicant, or person leading the project/program, has been engaged in the kind of activity for which funds are
requested for at least one year.
LCC grant funds will not be used:
to purchase food or refreshments.
on programming that discriminates or discourages participation on the basis of race, gender, religious creed, color, national
origin, ancestry, disability, sexual orientation or age.
The proposed project/program meets the MCC’s definition of one of the following disciplines (Select one primary discipline):
Arts Humanities Sciences
IF YOU CANNOT AFFIRM ALL OF THE ABOVE, YOU ARE NOT ELIGIBLE FOR AN LCC GRANT AND CANNOT SUBMIT AN APPLICATION.
CONTACT YOUR LCC OR THE MCC IF YOU HAVE QUESTIONS ABOUT THE LCC PROGRAM REGULATIONS AND GUIDELINES.
PROJECT INFORMATION
Project Title:
When will the project take place?
Where will the project take place?
Amount requested from this LCC: $ Estimated number of people served:
Does this project serve primarily schoolchildren (grades pre-K to 12)? Yes No
If yes, where does the project take place? In-school After/Out-of-school
Summarize the proposed project: (900 characters)
Who is the target audience for this project? (250 characters)
What is the cost of participation for attendees (if any)? (100 characters)
How does the proposed project provide public benefit and contribute to the cultural vitality of the community as a whole?
(750 characters)
Please describe the qualification of key artists, humanists, interpretive scientists or organizations involved with leading the
cultural component of this project. (750 characters)
If there are any other individuals or organizations that will be involved in the project as planners, partners, or collaborators,
please list them below. If applicable, please distinguish between those who have made a firm commitment to the project and
those with tentative or potential involvement. (500 characters)
How are you planning to promote the project to the community and your target audience? (500 characters)
BUDGET
**Hit the ‘TAB’ key after entering each number to ensure that the auto-calculation feature is activated**
Projected Expenses
How much will it cost to complete your project?
Salaries/Stipends
$
Space Rental
$
Marketing/Promotion
$
Supplies
$
Capital Expenditures (If greater than $0, also complete Section B)
$
Other Expenses: (travel, equipment rental, etc.)
$
$
$
$
$
$
Total Projected Expenses
$
Projected Income
How will you pay for expenses associated with your project?
Total Projected Expenses:
$
Amount Requested from this LCC: (under “Project Information”)
$
Additional Income Needed to Complete Project:
$
Additional Income needed must cover Total Additional Income.
If the additional income needed to complete your project is greater than $0, then please list the additional income you anticipate
obtaining to pay for all the projected expenses. See Sample Budget.
Description of funding source
Amount
$
$
$
$
$
$
$
Total Additional Income:
$
In-Kind Donations
Please list any in-kind goods or services that you anticipate receiving for this project (loaned space, donated materials, etc.).
While not required, if you would like to include the dollar value of in-kind donations, you may do so here or in the budget below. View
Sample Budgets: (500 characters)
How will you adjust the project if the council cannot fund the entire amount you are requesting? (For example, how will you
raise additional funds or scale the programming back?) (250 characters)
If you have applied to other Local Cultural Councils for funding for this specific project, please list the names of those
councils below: (250 characters)
Authorized Signature: The signature below is that of the person authorized to testify as to the accuracy of this application and the person who agrees that the required
acknowledgment will be given to the Massachusetts Cultural Council and the granting local cultural council, if this application is approved.
Signature Date
FOR CULTURAL COUNCIL USE ONLY SUBMITTED BY DEADLINE ___yes ____no
$
Amount Approved Signature of LCC Chair or Authorized LCC Member, Title, Date
PLEASE PRINT THE COMPLETED APPLICATION, SIGN IT AND MAIL IT TO YOUR LOCAL CULTURAL COUNCIL.
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LCC PROGRAM: STANDARD GRANT APPLICATION (City of Worcester)

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Completed 10 February 2021

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