Grant Application Form for Individuals

Application

Date of application *

Full name of applicant *

Address *

Phone *

Fax

Email *

Date of birth *

Are you a United States citizen? *

—Please choose an option—yesno

How did you hear about us?

Are you currently attending college or high school? *

—Please choose an option—collegehigh schoolno

If yes, please specify name of institution

Proposal category: *

—Please choose an option—Individual InstructionIndividual Project

Reason for applying for this grant *

Statement of need and project description: *

Will any other individuals participate in this project? *

—Please choose an option—yesno

If yes, explain their involvement

Anticipated starting date of project *

Anticipated ending date of project *

Total budget for project ($) *

Are you currently receiving other funding for this project? *

—Please choose an option—yesno

If yes, explain

Amount raised to date ($) *

How will you determine / evaluate your project’s success? *

Additional information to be considered? Please include any accessible web links to your performances, such as YouTube, Vimeo, SoundCloud, etc., that you wish to share.

If under 18 years of age, please identify a parent or guardian who will assume responsibility for financial transactions:

Name

Address

Phone

Fax

Email

Statement of Accountability

I attest that the information given above is accurate and that if I am awarded this grant, I will strive to the utmost of my ability to achieve the goals I have set, within the timeframe I have outlined **. I have read the submitted materials and give my approval for this grant request.

** Please note: Within one year following receipt of your grant, you will be required to attend BMFA’s next Awards Reception – in person or by video – explaining how your grant’s financial assistance made a difference to your success.