Artform Ofactivity

Artform Ofactivity

RegionalArtsDevelopmentFund

INDIVIDUALPROFESSIONALDEVELOPMENTGRANTAPPLICATIONFORM

APPLICANT DETAILS
Title Mr Mrs Ms Other(pleasespecify):
Name
Doyoulive in the CHRC region? Yes No
Age group under 18 18 – 25 25 – 55 55 +
Have youpreviouslybeen successful foraRADFGrant? Yes No
Ifyes,hasthatgrantbeensuccessfullyacquitted? Yes No
CONTACT DETAILS
StreetAddress
Suburb / State / Postcode
PostalAddress
Suburb / State / Postcode
Mobile / Home
Email
Website(if applicable)
ACTIVITY SUMMARY / ActivityTitle
ActivityBrief:(describetheactivityin100 wordsor less)
RADFGrantRequested$
TotalActivityCost$
StartDate / / EndDate / / OutcomeReportDueDate(8weeksfromenddate) / /

ARTFORM OFACTIVITY

Whatis theartformof youractivity?SelectONEonly

CommunityArtsandCulturalDevelopment Music Writing Dance

VisualArts,CraftandDesign Theatre Heritage Multi-arts

Central Highlands RegionalShireCouncil, POBox21,65 Egerton Street,EmeraldQLD4720

Ph1300 242 686•Fax1300 242 687 Email: ●Website:

ACTIVITYDETAILS AND BENEFITS – TOTAL ASSESSMENT 80%
WHO, WHAT, WHERE, WHEN AND WHY? – 40% / WHO? Whowillyouundertakethe activity with?Nameanyone involvedwith theactivitysuchas theartist, mentor, guest speakers etc.
WHAT? What does theactivity involve?Eg.Workshop, mentorship,attending conference….
WHERE? Wherewillyouundertakeyour project?Town,institution, studioetc.
WHEN? Whenwillyoubegoing?What is thetimeframeorkey dates tocompletetheactivity?
WHY? Howwillthisprojecthaveapositiveimpacton yourcareerorpractice?Willithelp youto…
  • Developnewskillsand knowledge?
  • Explorenewdirections inyourartsorcultural practice?
  • Takeyourcareertothe nextlevelof professionalism?
  • Developnew professionalindustry networks?
  • Developnewaudiences ormarkets?

Quality?– 5% /
  • Produces or contributes to high quality arts and cultural initiatives for local communities.
  • Capacity to efficiently support and deliver arts and cultural services.

Reach?– 5% /
  • Provides access to and engagement in arts and culture for diverse communities, practitioners, participants and audiences.
  • Evidence of local demand for proposed activities.
  • Contributes to addressing our local arts and cultural priorities.

IMPACT?– 5% /
  • Demonstrates cultural, artistic, social or economic returns on investment.
  • Addresses the QLD Government Objectives for the Community.

Viability?– 5% /
  • Evidence of good planning and management of the project.
  • Leverages additional investment and/or sources of income.
  • Evidence of partnerships.

Local benefit?– 20% / How will you give back to the local CHRC communities? EG workshops sharing your new skill.
BUDGET – TOTAL ASSESSMENT 20%
Pleaselistthedetailsforallof thecoststoundertakeyouractivity
Use wholedollarsonly
Enterallothergrantsforwhichyouhaveappliedfor,indicateifapprovedwith(A) Thetotalexpenditureandtotalincomemustequal
GST:ifyouareregisteredforGST, yourfiguresshouldbeexclusiveof GST.
EXPENDITUREITEMS
(pleaseprovidedetails,listadditionalexpensesasnecessary indicateiftheitemsisin-kindwith(IK)) / TOTAL VALUE
(List thetotal value oftheitem, including
in-kindvalue) / RADF CONTRIBUTION (Allocatewhereyour RADFGrant willbe spent this should equaltothegrant amountrequested)
Travel
Accommodation
Fees
Meals (not covered by RADF)
ProjectCosts
Administration
SOURCEOFINCOME (pleaseprovidedetails) / TOTALVALUE
RADFGrantRequested
ApplicantContribution-Financial
ApplicantContribution-In-Kind
OtherGrant/s
OtherContributionsFinancial
OtherContributionsIn-Kind
TOTALEXPENDITURE
TOTALINCOME
Demonstrate that attempts have been made to raise funds from other sources?
FINANCIAL INFORMATION / Completethissectionifyou/yourorganisation/grouphaveanABNandareresponsibleforthefinancial managementof thisgrantifsuccessful.IfyoudonothaveanABNpleasecomplete‘AuspicedApplication’
ABN / GSTRegistered Yes No
RegisteredName
TradingName(if relevant)
AUSPICED APPLICATION / CompletethissectionifyoudoNOThaveanABNandyouarenominatinganaccountableorganisationor individualto administerthegranton yourbehalf.
Pleasenote:Boththeapplicantand theauspicingorganisation/individualareconsideredresponsiblefor ensuringtheacquittalof grantsandbothcouldbedeemedineligibletosubmitfurtherRADFapplicationsuntil allgrantshavebeensatisfactorilyacquitted.
Whoisyourauspicingarrangement
with? an incorporatedorganisation anindividual
Nameof AuspiceBody
ABN / GSTRegistered Yes No
CONTACTPERSON
Title Mr Mrs Ms Other(pleasespecify):
Name
Role(if relevant)
PostalAddress
Suburb / State / Postcode
Email
CERTIFICATIONBYAUSPICINGORGANISATION/INDIVIDUAL
I/myorganisationagree/stoadministerthegrantthatmaybeofferedto theapplicantontheirbehalfandthat the informationstatedinthe‘auspicedapplication’sectionofthisapplicationistrueandcorrect.
Signature Date:
Nameinfull
Role(if relevant)
CERTIFICATION / I,theundersigned,certifythat:
I havereadandwillabideby theRADFCommunityProjectGrantGuidelinesdocument
Thestatementsin thisapplicationaretrueandcorrectto thebestofmyknowledge,informationandbelief andthe supportingmaterialismyownworkortheworkof theartistsnamedin thisapplication.
I havereadandunderstoodtheInformationPrivacyandRightto InformationStatementandagreetothe useanddisclosureofinformationas outlinedin theStatement.
Signature
Ifyouareunder theageof18yourlegal Date:
guardianmustalsosignthisapplication
Nameinfull
Position(if applicable)
Signatureof Guardian Date:
Nameinfull

INFORMATIONPRIVACYANDRIGHTTOINFORMATION

Theinformationyouprovideinyourgrantapplicationwill beusedbytheRADFCommitteeandCentral Highlands Regional Counciltoprocessand assessyourapplicationand,ifsuccessful,to process,payandadministeryourgrant.Otherfundingagenciesidentifiedin yourapplication maybecontactedto verifygrantsrequested.

Ifyourapplicationissuccessful,thefollowinginformationmaybedisclosedto Arts Queensland:

the informationyouprovideinyourgrantapplication the amountoffundingyoureceive

the informationyouprovideinyouroutcomereportand textandimagesrelatedto yourfundedactivity.

TheInformationmaybe usedbyCentral Highlands Regional CouncilorArts Queenslandforreportingpurposes,training,systemstestingandprocess improvement.TheInformationmaybemadeanonymousandusedforstatisticalpurposes.ItmayalsobeusedinthepromotionofRADF orthepromotionoffundingoutcomesforarts andculturaldevelopmentin Queensland.Forthispurpose,theInformationandyourcontact detailsmaybeprovidedtoQueenslandGovernmentMembersof Parliament,themediaandotheragencieswhomaycontactyoudirectly. Central Highlands Regional CouncilandArts QueenslandmayalsopublishtheInformationin their AnnualReportsorontheirwebsites.

Central Highlands Regional CouncilandArts QueenslandtreatallpersonalinformationinaccordancewiththeInformationPrivacyAct2009.The provisionsof theRighttoInformationAct2009applytodocumentsin thepossessionof Central Highlands Regional CouncilorArts Queensland.

APPLICATIONCHECKLIST
IhavediscussedmyactivitywiththeRADFLiaisonOfficer(RLO)
IhavereadandunderstoodtheCHRC RADFGrantGuidelinesdocument
Allsectionsof theApplicationFormhavebeencompletedandtheapplicationis signedanddated
Ihavecheckedthebudgetandconfirmitbalances
ESSENTIALSUPPORTMATERIALEssentialitems MUSTbeincluded for theapplicationtobeeligible
QuotesorcalculationsforexpenditureitemsRADFis supporting
Letterof acceptance/confirmationintonominatedactivityorletterof support
1pageArtistCVoracompletedArtistChecklist
RECOMMENDEDSUPPORTMATERIAL-Recommendeditemswillstrengthenyourapplication

Supportmaterialconfirminganydonations/sponsorship,in-kindpartnerships,grantsuccess
1pageArtistCVordetailsabouttheartist/organisationyouwill work with
Ifyoudonothaveawebsite,facebookpage whereassessorscanseeexamplesofyouwork,provideupto 3highquality
JPEGimages

SUPPORTMATERIAL:ARTISTCHECKLIST

TheRADFCommittee willusethefollowinginformation toevaluateyourcareerstatusasanartistandhowthisprojectwill helptodevelopyourpractice.RADFaimstosupportprofessional andemergingartistsandartsworkers topracticeexcellent artforandwithcommunities.Usethisformifyoudo nothavean artistCVtooutlineyourpractice.
Iaman: Emergingartist/artsworker Establishedartist/artsworker
Pleaseindicateachievementsbelow,tobeeligibleforRADFfundsyoumustbeabletotickatleast3items.
IfyoucannottickthreeitemspleasecontacttheRLOtodiscussfurtherasspecialconsiderationmaybe given.
Ihaveprofessional artsand/orcultural qualifications. / Listqualification/syear
Ihaveheldpublic exhibitionsorgiven publicperformances (notaspartof a competition). / Listrecentexamples:
Ihavework heldin publiccollections. / Listcollection/s:
Ihavewonimportant nationaland/or international prizes/awards. / Listprizeyear:
Ihavewonregional or localart prizes/awards. / Listprizeyear:
Ihaveheldpublic discussionsand/or havehadarticles writtenaboutmy work. / Listarticle/discussionyear:
Iamamemberof a professional association/sasa professionalartist. / Listcurrentmemberships:
Ihavebeencommissionedoremployedon thebasesof artskillsand/orearningincomefrom salesof artwork
Ihavedevotedsignificanttimetoartspractice
Ihavebeenrecognisedasaprofessionalbypeers
Iamanartist whoseartisticorculturalknowledgehasbeenrecognisedasprofessionalbypeersorthecultural community
Iamanartist whoseartisticorculturalknowledgehasdevelopedthroughoraltraditions
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