The Shubert Foundation

THE SHUBERT FOUNDATION 2013-14

Form 1Page 2 of 2

THE SHUBERT FOUNDATION

2013-14

Grant Application

NOTE: Please use ‘tab’ to move from field to field when filling out electronic version of this application ( Applications must be printed and mailed to The Shubert Foundation; applications cannot be submitted via e-mail.

1.Legal name of organization
2.Popular name (if different)
3.Mailing address / City / State / Zip Code
4.Street address (if different)
5.Office phone / 6.Fax
7. Website
8. Name and title of person completing this application
9. E-mail & telephone number & extension of person listed above
10. Primary contact person’s name and title (if different from above)
11. E-mail & telephone number & extension of person listed above
12. No. of years as 501(c)(3) organization / 13. First year of operation / 14. 509(a) status (i.e, 1, 2 or 3)
15.Month fiscal year ends / 16. Number of full-time staff members
17. List (below) principal administrative and artistic staff by name, title, total annual compensation and number of years
affiliated with organization. (If years in current position is different from total years with organization, please note.)
Compensation information may be submitted in a sealed envelope, but principal staff must be listed below.
Name / Title / Years / Compensation

18. List board of directors; identify officers. (Not required of Education applicants.)

Name / Professional Affiliation / Years on Board

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THE SHUBERT FOUNDATION 2013-14

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ALL APPLICANTS (except Education)

Describe the mission and principal programs of the organization. List programs in order of importance.

2. Is your organization affiliated with a college or university? If so, describe affiliation(s) and financial support received, if any.

3. Describe your organization’sprimary physical facilities (dimensions, capacity, age, etc.). State whether owned,

rented, donated or shared. If owned, state outstanding debt (if any). If rented, state annual rent.

(Not required for companies that tour exclusively.)

4. List the professional contracts under which your company operates, e.g., LORT, AEA, IATSE, SSDC,

Dramatists Guild, etc. Specify LORT tier, Letter of Agreement terms, etc.

5. State range of performer compensation

6. THEATRE COMPANIES:

Do you maintain a resident company (actors employed full time throughout season)?
If so, how many?

7. DANCE COMPANIES:

Number of dancers on contract (excluding apprentices)
Number of weeks in contract / Number of apprentices

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THE SHUBERT FOUNDATION 2013-14

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8. List significant contributions your organization has made to the field.

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THE SHUBERT FOUNDATION 2013-14

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9.PAST THREE SEASONS:

List fully staged, professional works your company produced/presented for the general public.
List productions separately by season; provide titles, authors, directors, running dates, andvenue, i.e., Main or Second Stage.

Please use first column to notepremieres, second, and third productions(use AP for American premieres, WP for world premieres, WPC for world premiere commissions and 2P and 3P for second and third productions; Dance companiesonlyuse CP for company premieres),readings (R), workshops (W),andbooked/presentedproductions (B/P).

Do not list space rentals.

For Dance companies only: please use the “Author” column to list composers and the “Director” column to credit choreographer(s).

PRODUCERS: Send one set of reviews covering each production of the last two seasons. Please send more than one review per production whenever possible. Reviews must not be edited for length or content.

Season / Title / Author/
Composer / Director/
Choreographer / Venue / Co-Producer(s) / Dates

(Continued)

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THE SHUBERT FOUNDATION 2003-04

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Season / Title / Author/
Composer / Director/
Choreographer / Venue / Co-Producer(s) / Dates

Rev July 2003

THE SHUBERT FOUNDATION 2013-14

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10.2013-14 SEASON:

List fully staged, professional works your company plans to produce/present for the general public.
Provide titles, authors, directors, running dates, and venue, i.e., Main or Second Stage.

Please use first column to note premieres, second, and third productions (use AP for American premieres, WP for world premieres, WPC for world premiere commissions, 2P and 3P for second and third productions; Dance companiesonlyuse CP for company premieres), readings (R), workshops (W), andbooked/presentedproductions (B/P). Do not list space rentals.
For Dance companies only: please use the “Author” column to list composers and the “Director” column to credit choreographer(s).

Season / Title / Author/
Composer / Director/
Choreographer / Venue / Co-Producer(s) / Dates
Season / Title / Author/
Composer / Director/
Choreographer / Venue / Co-Producer(s) / Dates

NOTE: If season schedule changes, please send update byMonday, December 16, 2013 (Dance and Arts Related),or by Monday, February 3, 2014(Theatre).

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THE SHUBERT FOUNDATION 2003-04

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Season / Title / Author/
Composer / Director/
Choreographer / Venue / Co-Producer(s) / Dates

NOTE: If season schedule changes, please send update byMonday, December 16, 2013 (Dance and Arts Related), or by Monday, February 3, 2014 (Theatre).

Rev July 2003

THE SHUBERT FOUNDATION 2003-04

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ATTENDANCE AND REVENUE:

Provide information on fully staged, professionalproductionsfor thegeneral public. (Do not include benefit events, readings, workshops or outreach/education programs, unless such work is organization’s primary function.)
If more than one performance space, venue or series, complete separate form (6a, 6b, etc.)for each.
Touring companies should complete Nos. 11-24 for home-base performances only. Companies that have home seasons, but also tour full productions for the general public, should complete No. 25.
Please fill out these pages carefully anduse form 2 page 6c for narrative explanation of ticket sales, including comparisons between 11/12 and 12/13.

11/12 Season: / 11. Space/venue
12. Total number of subscribers / 13. Total number of performances
14. Number of performance weeks / 15. Number of seats sold
(do not include comps)

12/13Season:

16. Total number of subscribers / 17. Space/venue
18. Number of performance weeks / 19. Number of seats in house
20. times total number of performances / X
21. equals total number of seats available for season (total capacity) / =

Attendance breakdown:

Number / $ Received
(a) Individual tickets sold / $
(b) Subscriptions * / $
(c) Unpaid admissions (comps) ** / 0.00
(d) Total number ofseats occupied in a season / $

*Count each performance separately. (A $25 subscription for 5 performances

would require a 5 in the "Number" column and $25 in the "$ Received" column.)

** For free programming (and/or student matinees), use separate page.

23. Number of performances scheduled for 13/14
12/13 / 13/14
24. Ticket price range (do not include comps)
25. TOURING:
(a) 1. Number of touring performances in 11/12 season / Numberof 11/12venues
2. Number of 11/12 seats sold / Revenue for 11/12 touring performances
(b) 1. Number of touring performances in 12/13 season / Number of 12/13venues
2. Number of 12/13 seats sold / Revenue for 12/13 touring performances
(c) Touring performances scheduled for13/14season / Number of 13/14venues

(Continued)

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THE SHUBERT FOUNDATION 2013-14

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11/12 Season: / 11. Space/venue
12. Total number of subscribers / 13. Total number of performances
14. Number of performance weeks / 15. Number of seats sold
(do not include comps)

12/13 Season:

Attendance breakdown:

Number / $ Received
(a) Individual tickets sold / $
(b) Subscriptions * / $
(c) Unpaid admissions (comps) ** / 0.00
(d) Total number ofseats occupied in a season / $

* Count each performance separately. (A $25 subscription for 5 performances

would require a 5 in the "Number" column and $25 in the "$ Received" column.)

** For free programming (and/or student matinees), use separate page.

23. Number of performances scheduled for 13/14
12/13 / 13/14
24. Ticket price range (do not include comps)
25. TOURING:
(a) 1. Number of touring performances in 11/12 season / Numberof 11/12venues
2. Number of 11/12 seats sold / Revenue for 11/12 touring performances
(b) 1. Number of touring performances in 12/13 season / Number of 12/13 venues
2. Number of 12/13 seats sold / Revenue for 12/13 touring performances
(c) Touring performances scheduled for13/14season / Number of 13/14 venues

(Continued)

11/12 Season: / 11. Space/venue
12. Total number of subscribers / 13. Total number of performances
14. Number of performance weeks / 15. Number of seats sold
(do not include comps)

12/13 Season:

Attendance breakdown:

Number / $ Received
(a) Individual tickets sold / $
(b) Subscriptions * / $
(c) Unpaid admissions (comps) ** / 0.00
(d) Total number of seats occupied in a season / $

* Count each performance separately. (A $25 subscription for 5 performances

would require a 5 in the "Number" column and $25 in the "$ Received" column.)

** For free programming, use separate page.

23. Number of performances scheduled for 13/14
12/13 / 13/14
24. Ticket price range (do not include comps)
25. TOURING:
(a) 1. Number of touring performances in 11/12 season / Numberof 11/12venues
2. Number of 11/12 seats sold / Revenue for 11/12 touring performances
(b) 1. Number of touring performances in 12/13 season / Number of 12/13 venues
2. Number of 12/13 seats sold / Revenue for 12/13 touring performances
(c) Touring performances scheduled for13/14season / Number of 13/14 venues

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THE SHUBERT FOUNDATION 2005-06

Form 2Page 6c of 6

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26. Please use space below to explain attendance and revenue figures reported on preceding pages. If figures vary significantly from the previous year, you must provide details that may have contributed to these variances. In addition, use the space to include any attendance and revenue information not accommodated by the forms (i.e., SRO tickets, weather-related or other extraordinary circumstances, etc.)

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UNIVERSITY DRAMA DEPARTMENTS ONLY

NOTE:Theatre companies affiliated with universities should complete Form 2.

1. Describe your program, detailing the emphasis placed on performance, technique, history, etc. List degrees offered.

2. List the recent achievements of your program.

3. List prominent faculty members currently teaching in your program.

THE SHUBERT FOUNDATION 2013-14

Form 3Page 2 of 2

4.List recent graduates (past 10 years) who have achieved prominence in the performing arts.

5.Is your program an independent school within the university, an independent department, or

part of another department or program?

6.Does your department/program have its own budget?

7.Total number of students currently enrolled / University / Drama Dept.
Graduate
Undergraduate
8.Total number of degrees awarded last year / University / Drama Dept.
Graduate
Undergraduate
9.Total number of full-time faculty members / University / Drama Dept.
10.Annual tuition charge for full-time students* / Graduate / Undergraduate

11. Please attach a single page describing how funding might be utilized to create a Shubert Scholarship program (to be managed and administered by the Education grantee).

THE SHUBERT FOUNDATION 2013-14

Form 4Page 1 of 4

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Your application will not be considered unless you submit the requisite financial information.

Please read these instructions carefully before completing Form 4.

The following financial statement requires a comparative presentation of the revenues and expenses of the organization for the last completed fiscal year and the current fiscal year.

The “Current Fiscal Year” includes both actual and budgeted amounts; the "Actual to Date ___ Months" column is for recorded results from the part of the year that has already passed and the "Budgeted For Rest of Year ___ Months" column is for amounts projected for the remainder of the year. The amounts in those two columns should total to the amounts in the "Total For Current Year" column.

IMPORTANT: The Shubert Foundation receives applications from a diverse group of organizations. We recognize that the following forms do not allow for explanations. If the figures you provide differ significantly from the corresponding audit (due to FASBregulations or other circumstances) and/or require clarification in order to provide a more accurate fiscal profile of your company, please use the space below to provide further details.

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THE SHUBERT FOUNDATION 2013-14

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Form 4 FINANCIAL STATEMENT
Current Fiscal Year Ends
1. Basis of Accounting
accrual cash / Most recent completed fiscal year ended mm/dd/yy / Actual to date (___ months) / Budgeted for rest of year (___ months) / Total for current year (12 months)
2. EARNED REVENUES
(a) Admissions, subscriptions, etc.
(b) Concessions (net), parking, etc.
(c) Fees from students, workshops, etc.
(d) Auditorium rentals
(e) Services other than performances (explain)
(f) Other earned revenue (explain)
(g) TOTAL EARNED REVENUES
3. OTHER REVENUES
(a) Board contributions
(b) Contributions from individuals
(non-Board)
(c) Corporate contributions
(d) Foundation grants
(e) Local government funding
(f) State arts council
(g) National Endowment for the Arts
(h) Income from investments, securities profits (net)
(i) Fundraising special events (net)
(j) Production enhancement
(k) Other (explain)
(l) TOTAL OTHER REVENUES
(m) TOTAL ALL REVENUES
[2(g) + 3(l)]

(Continued)

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THE SHUBERT FOUNDATION 2013-14

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Form 4 FINANCIAL STATEMENT
Current Fiscal Year Ends
Most recent completed fiscal year ended ______mm/dd/yy / Actual to date (___ months) / Budgeted for rest of year (___ months) / Total for current year (12 months)
4. OPERATING EXPENSES
(a) Personnel costs
Administrative
Artistic/Production
Other (explain)
(b) Production costs other than personnel
(c) Royalties
(d) Commissions
(e) Rent (if multiple spaces, explain)
(f) Advertising, promotion
(other than fundraising)
(g) Heat, electricity, telephone, etc.
(h) Computer systems/services
(i) Maintenance and supplies
(j) Fundraising costs
(k) Outside accounting, legal, insurance, etc.
(l) Amounts disbursed to other organizations or individuals
(m) Other operating expenses (explain)
(n) TOTAL OPERATING EXPENSES

ANALYSIS OF SURPLUS

(OR DEFICIT) FOR PERIOD
(a) Surplus (or deficit) from operations
[2(g) less 4(n)]
(b) Surplus (or deficit) after contributions, etc.
[3(m) less 4(n)]

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THE SHUBERT FOUNDATION 2013-14

Form 4Page 4 of 4

USE ADDITIONAL SPACE, IF NECESSARY

List corporate and foundation (not government) grants of $2,500 or more. Note multi-year grants and in-kind contributions;

specify purpose of each earmarked grant.

List government grants on Form 4, Page 2.

Photocopies of patron acknowledgments from playbills are not acceptable.

GRANTOR / AMOUNT RECEIVED
12/13 / AMOUNT RECEIVED OR PROJECTED
13/14
(Indicate Received with R, Projected with P)

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Print/Retain for your records

THEATRE APPLICANTS

THE SHUBERT FOUNDATION

2013-14

Application Checklist

The following materials must be received by the Foundation no later than 6pm, onMonday, December 2, 2013:

PLEASE SUBMIT MATERIALS IN THE FOLLOWING ORDER:

All applicants Cover letter and application (stapled)

Photocopy of cover letter and application (stapled)

501(c)(3) IRS tax-exemption letter (must be current and legible)

Audited financial statements; one original and one photocopy.

(For more information regarding financial

statements, see Instructions for Grant Applications.)

Producing companies2013-14 touring schedule (if applicable; do not include ancillary education/outreach touring programs)

Producing companies

and PresentersOne set of reviews from past two seasons (stapled together)

Playbill / program from current or most recent season

2013-14(or most recent) season brochure

The following materials must be received by the Foundation no later than 6pm on

Monday, February 3, 2014:

All applicantsAudited financial statements; one original and one photocopy

(See Instructions for Grant Applications)

Producing companies

and Presenters 2013-14 season update (only if schedule has changedsince December 3).

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Print/Retain for your records

DANCE, ARTS RELATED

AND EDUCATION APPLICANTS

THE SHUBERT FOUNDATION

2013-14

Application Checklist

The following materials must be received by the Foundation no later than 6pm, on

Tuesday, October 15, 2013:

PLEASE SUBMIT MATERIALS IN THE FOLLOWING ORDER:

All applicants Cover letter and application form (stapled)

Photocopy of cover letter and application (stapled)

501(c)(3) IRS tax-exemption letter (must be current and legible)

Audited financial statements; one original

and one photocopy. (For more information regarding financial statements, see Instructions for Grant Applications.)

Producing companies2013-14 touring schedule (if applicable; do not include ancillary education/outreach touring programs)

Producing companies

and PresentersOne set of reviews from past two seasons (stapled together)

Playbill/ program from current or most recent season

2013-14 (or most recent) season brochure

Materials must be received no later than 6pm onMonday, December 16, 2013

(earlier, if possible):

All applicants

Audited financial statements; one original and one photocopy

(See Instructions for Grant Applications)

Producing companies

and Presenters 2013-14 season update (only if schedule has changed since October 15).

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