Application Form Forarts Capacity Developmentfunding Scheme (ACDFS)

To : / Secretariat
Arts Capacity Development Funding Scheme
Home Affairs Bureau
25/F, Wanchai Tower, 12 Harbour Road
Wan Chai, Hong Kong / (Official Use Only)
Date of Receipt : _____
Reference No. :______

Application Form forArts Capacity DevelopmentFunding Scheme (ACDFS)

Springboard Grants

(5th-Round Application: November 2015)

(Deadline:6pm on 8January 2016)

Applicant(s) /Organisation(s) (Eng)
(Chi)

Please read carefully the Guide to Application for Arts Capacity Development Funding Scheme(Guide to Application) available at the Home Affairs Bureau’s website at before completing this Form.
Successful applicant/organisation must be a non-profit sharinglegal entity capable of entering into a funding agreement with the Government. For newly established companies/groups where documentary evidence pertaining to applicant’s legal status as required in Section A is not available at the time of application, such documentary evidence should be provided to the Secretariat before signing the Funding Agreement.
If the proposed initiative/project will be organised by two or more individuals/organisations, the principal or lead individual/organisationshould fill in this form, and a joint application should be submitted with the consent of the joint applicant(s)/organisation(s). Please note details in Chapter 4 - “Eligibility” in the Guide to Application.
Each applicant/organisation can only submit one application.
Please submit the application form (both the original and photocopies) in duplex printing without binding. Applicant/Organisationcan attach supplementary sheet(s) if more space is required, but be reminded that some parts of the form have word limits, and submission should be kept within the stated limits.
Please provide all information requested in this form and attach relevant supporting documents to facilitate assessment of the applications.
If there are changes to applications submitted, please notify the Secretariat and provide a complete set of replacement application to the Secretariat before the submission deadline (6 pm on 8January 2016).
If the applicant/organisation fails to submit the required information and the relevant supporting document(s) set out in the Guide to Application, the application may not be further considered.
All information (including without limitation the application form, relevant supporting documents, video and audio recording, documentation, USBscompact discs, etc.) submitted by the applicant/organisation will not be returned.

Section A – Particulars of theApplicant/Organisation
In case of a joint application, the principal applicant/organisation should fill in this form and supply all necessary information with the consent of the joint applicant(s)/organisation(s).

Information of Applicant/Organisation

Name*(Eng)
(Chi)
Registered Address*(Eng)
(Chi)
Tel No.* / Fax No.
EmailAddress*
Website

Name and Details of Contact Person

Name*(Eng)
(Mr/Ms)#(Chi)
Post (Eng)
(Chi)
CorrespondenceAddress*(Eng)
(Chi)
Tel No.* / Fax No.
EmailAddress*

Background and Activities

(A) History of your organisation

* Completion is mandatory

# Please delete as appropriate Section A

(B) Core activities organised and services provided by your organisation
(C)Sources of funds and income of your organisation

Registration Information

(Please attach documentary proof and provide photocopies of relevant registration certificates and the Company’s Memorandum and Articles of Association, whichever is applicable.)
The legal status that your organisation has acquired# or will acquire# (Please tick as appropriate) :
Charitable institution and trust of a public character under section 88 of the Inland Revenue Ordinance (Cap. 112)
Company limited by guarantee incorporated under the Companies Ordinance (Cap. 622) or old Companies Ordinance (Cap. 32)

# Please delete as appropriate

Section A

Date of Establishment / Number of Members
Background andObjectives of YourOrganisation
Board of Directors
(if applicable)
Key Personnel and/or Management Team
(If any member(s) of the key personnel and management team will also be the key artistic personnel, the applicant/organisation shall givedetails of the member(s) in Part 3(C) of Section B as well.)
Please fill in the following sections if this is a joint application and use a separate sheet for each of the joint applicants/organisations in addition to the one specified in Items 5-6 below.

Information of Joint Applicant/Organisation

Name* (Eng)
(Chi)
Registered Address* (Eng)
(Chi)
Tel No.* / Fax No.
EmailAddress*
Website

* Completion is mandatory

Section A

Experience(s) in Running Arts Activities
Nature and Details of Collaboration with the Principal Applicant/Organisation

Registration Information of Joint Applicant/Organisation

# Please delete as appropriate

Section A

Board of Directors
(if applicable)
Key Personnel and/orManagement Team
(If any member(s) of the key personnel and management team will also be the key artistic personnel, the applicant/organisation shall givedetails of the member(s) inPart 3(C) of Section B as well.)

Section A

Section B – The Proposal

Title

(Eng)
(Chi)

Details of theProposal
(e.g. scale, nature and significance)

(A)Please indicate to which category the proposal belongs[1]
(Please tick one box only)
☐ Arts Administration / ☐ Arts Education
☐ Community Arts / ☐ Dance
☐ Media Arts / ☐ Multi-disciplinary Arts
☐ Music / ☐ Theatre
☐ Visual Arts / ☐ Others
Please specify:
(B)Summary of Proposal
(Please provide a summary outline/highlightsof your proposal in not more than 300 words)

Section B

(C)Details of Proposal
(Please attach supplementary sheets if necessary)

Staffing/Key Personnel for Organising and Implementing the Proposal

(A)Project/Operation Coordinator / (B)Deputy Project/OperationCoordinator
Name (Eng)
(Mr/Ms)# / Name (Eng)
(Mr/Ms)#
Name (Chi) / Name (Chi)
Post / Post
Organisation / Organisation
Address / Address
Tel No. / Tel No.
Fax No. / Fax No.
Email Address / Email Address
Website / Website
Expertise / Expertise
Qualifications
Experience / Qualifications
Experience

# Please delete as appropriate

Section B

(C)Key Artistic Personnel
(For those key artistic personnel who are not members of your organisation, please enclose their notification(s) or letter(s) of intent to show that they know about the application.)
Name / Capacity/Responsibility / Qualification/Expertise/Experience
(Please attach supplementary sheets if necessary)
a
b
c
d
e
(D)Please provide a brief description of other supporting staff and their responsibilities.

Impact on Local Arts Development and the Community

Please define the existing role and position of your organisation in the arts sector with respect to your existing capacity and strength.

Objectives and Goals

(A) Please give concise account of each of the objective/goal (up to 300 words) that you aim to achieve. You may provide further details, if any, by attaching supplementary sheets to this application. (Applicant/Organisation may refer to Chapter II – “Objectives” of the Guide to Application when completing this item.).
Capacity Development
Programme/
Content Development
Audience Building
Arts Education

(B) Please state how the proposal will help bring development to your organisation as well as impact on the art form(s) or the arts sector as a whole. Please elaborate especially on those impacts on local arts development and the community which are not covered in item 5(A).

Feasibility Evaluation
(The evaluation may include the demand of the community and the availability of venues, talent and expertise required in regard to your proposal.)

Time-line

(Please set out the major tasks to be completed in each stage.)

Note:The funding period of a Springboard Grant and a consecutive Springboard Grant may last for a maximum period of 2 and 3 years respectively. Applicants/Organisations are encouraged to maximise the use of the allowable funding period.

Stage/Phase
(if any) / Period
(day/month/year) / Milestones
(e.g. drawing up of promotion strategy, confirmation of venues, launching of publicity campaign, etc.) / Deliverables
(e.g. activities, exhibitions, performances, publications, etc.)
/ / to / /
/ / to / /
/ / to / /
/ / to / /
/ / to / /

Continuous Development (only applicable to Consecutive Grant applicants)

(Please state how this proposal will further elevate your organisation’s professionalcapacity on top of the deliverables achieved with the first-timeSpringboard Grant and bring about continuousdevelopment upon completion of the proposal implemented with the Consecutive Grant. Please provide more details in supplementary sheets if necessary.)

Implementation Strategy

(Please state how to implement and administer your proposal and achieve your milestones and deliverables with effective manpower and resource deployment.)

Intellectual Property Rights
(Please indicate whether this proposal would generate or involve any Intellectual Property Rights and give details, including the nature of the Rights and the handling method.)

Marketing and Promotion Strategy

(Please state channels/means of marketing and promotion, including marketing and promotion to audience, members of the public, sponsors/donors, etc. and expected benefits to be achieved.)

Evaluation Method(s)

(A) Please propose qualitative and quantitative performance indicators and ways to measure achievement.
Qualitative
Performance Indicators / Ways to Measure Achievement
Quantitative
Performance Indicators / Ways to Measure Achievement
(B) Please propose the evaluation methods (e.g. feedback survey(s), media report(s), etc.) to be used for assessing the effectiveness of yourproposal. Evaluation in respect of performance indicators, deliverables/target and/or key milestones is recommended.

Risk Assessment

Please list the most probable risks which your proposal may be subject to / Please state possible solutions, risk control/contingency measures against the risksprojected in the left hand column

Section B

Section C – Financial Viability

Budget

(Applicant/Organisation is required to submit a proposed budget for implementing the proposal, showing all expenditure and sources of funds and income (including but not limited to non-government sponsorship and/or donation, income and revenue) together with justifications and calculation. Please append breakdown of the estimates(including estimates for individual events) by attaching supplementary pages to this application.)
(I) Income and Sponsorship (Value in HK$)
Item(s)
(Please itemise) / Form of Income / Total / Remarks
(A) Major Income
(B) Sponsorship/Donations
(C) Others
EstimatedIncome and Sponsorship
from other sources
(A) + (B) + (C)
(D) Amount of Funds required from the ACDFS
Total Income
(A) + (B) + (C) + (D)

Section C

Detailed Explanation
(Please provide details for each income item.[2])
(A)Major Item(s) of Income
((Please itemise estimated income to be generated from the proposal and show the calculation of each item.)
(B)Non-government Sponsorship/Donations to be Matched
(Please submit documentary proof (e.g. Letter of Intent, Sponsorship Letter, etc.) on non-government sponsorship/donations secured orto be secured.)
(Value in HK$)
Amount of the Sponsorship/Donations
(Please itemise) / Name(s) of the sponsor(s)/
donor(s) / Has been secured/
To be secured / Documentary
Proof
Has been secured/
To be secured# / Attached
Has been secured/
To be secured# / Attached
Has been secured/
To be secured# / Attached
Has been secured/
To be secured# / Attached
(C)Others(Please list out items separately, e.g. advertising and sale of souvenirs.)

#Please delete as appropriate

Please put a tick in the appropriate box(es)Section C

(II) Expenditure
(Please provide breakdown of the estimates, including estimates for individual events, by attaching supplementary pages. Applicant/Organisation may refer to Chapter XI – “Unallowable Costs” of the Guide to Applicationwhen completing this item.)
(Value in HK$)
Item(s)
(Please itemise) / Total / Remarks
(A) Manpower[3] (including administrative, promotional, co-ordinating staff, etc.)
Subtotal (A)
(B) Equipment and Services
Remuneration for artistic personnel
Technical services
Production costs (e.g. set, props, costume,fabrication, lighting and sound, etc.)
Venue Rental [4]
Expenses for visiting artistic personnel (e.g. airfare, accommodation, etc.)
Subtotal (B)
(C) Other Direct Costs
Insurance
Audit Cost(Ceiling fee at $20,000)
Contingency/Miscellaneous
(Ceiling expenses is 3% of the total ACDFS grant applied)
Promotion & publicity (e.g. Design, printing, distribution, etc.)
Subtotal (C)
Total Project Cost
(A) + (B) + (C)

Section C

(III) Cash Flow Projection[5] (Value in HK$)

1st Instalment / 2nd Instalment / 3rd Instalment
(if applicable) / 2nd last
Instalment / Final
Instalment
Period
(mm/yy) / /
to
/ / /
to
/ / /
to
/ / /
to
/ / /
to
/
(A)Receipts
Springboard Grants
Other income
Balance of the
previous instalment / /
Sub-total (A)
(B)Payments
Expenses
Sub-total (B)
Net cash flow
requirement
(A) – (B)
2. Financial Control
Please list out measures of cost/budget control for implementing the proposal.

Section C

3. Proposed Arrangement for Residual Funds/Operating Surplus or Deficit [6]
Please propose plans/initiatives (with full details including objectives, timeline, estimated budget) for the use of residual funds/operating surplus after completing the proposal. In case the proposal will result in a deficit, please propose plans to cover any shortfall necessary in implementing and completing the proposal. (Please provide details in supplementary sheets if necessary)
4. Other InformationRelating to the Proposal
(A) Have you/Has your organisation applied for the ACDFS before?
Yes
Year / Title of the Proposal
Please answer (B) below.
No (Please to (C) below)
(B) Have you/Has your organisation submitted a proposal for the same initiative/project before?
Yes (Please provide new information and documents which show that an in-depth review of the proposal has been made or indicate the parts where significant and substantial changes have been made to the proposal. [7])
No
(C) Has a proposal for the same initiative/project been submitted (or will be submitted) to apply for funding/support from other public funding sources and/or Government Bureaux/Departments?
YesNo
If Yes, please give details and may refer to paragraph 3.2 –“Double Subsidy” in the Guide to Application.
(D)Supplementary Information (if applicable) – Applicant/Organisation may provide any other relevant information in support of this application:

Please put a tick in the appropriate box(es)

Section C

Section D – Personal Data

The personal data collected in the application forms will be used by the Government and the Advisory Committee on Arts Development for the following purposes:

(a)processing and assessing the applications for the Arts Capacity Development Funding Scheme;
(b)conducting research;
(c)recording and preparing statistics;
(d)arranging public announcements and publicity;
(e)monitoring and evaluating the funded proposal; and
(f)taking any remedial or follow-up action on the funded proposal.
For the purpose of (a), the application form and the personal data therein may be passed to public organisations including, but not limited to, the Hong Kong Arts Development Council and/or the Leisure and Cultural Services Department for cross reference.

Under the Personal Data (Privacy) Ordinance, Cap.486, you have the right to request access to and correction of your personal data. If you wish to exercise these rights, please complete and return the prescribedPersonal Data Access Form to the Secretariat of the Arts Capacity Development Funding Scheme. You are asked to note that the provision of personal data marked * on the Application Form is mandatory, failure to provide such personal data will result in your application being rejected.

Section E – Declaration by the Applicant/Organisation and the Joint
Applicant(s)/Organisation(s) (if applicable)
(a)We certify that all information provided in this application and the accompanying information is true and accurate. We understand that giving any false or inaccurate information or withholding any material information will render the application null and void. We undertake to inform the Secretariat immediately if there are any subsequent changes to the above information.
(b)We declare that if the application is approved, utmost dedication and determination will be given to complete and monitor the proposal according to the proposal stated in this application.
(c)We declare that if the application is successful, we will relinquish the One-Year/Two-Year/Three-Year Grant of the Hong Kong Arts Development Council to avoid double subsidy.
(d)We certify that the organisation and implementation of the proposal, and the use or possession by the Government and its authorised users, assigns and successors-in-title of any materials provided by us does not and will not infringe any intellectual property rights of any party.
(e)We agree that information provided in this application may be used by the Government to process this application and related purposes. We authorise the Secretariat to handle the personal data/information provided in this application form for these purposes.

Section DE

(f)We agree that information contained in this application form and any subsequent submissions (including all its appendices, attachments, supplements and revisions) may be used or disclosed for public announcements and publicity.
(g)We agree to grant and procure the relevant third party intellectual property rights owners to grant the licence to the Government, its authorised users, assigns and successors-in-title to copy, access and circulate any information and materials in the application form and the accompanying documents for the purpose of vetting and assessment of applications. The term “authorised users” includes members of Advisory Committee on Arts Development and its Expert Advisers.
(h)We have read and understand the contents of the Guide to Application and agree to be bound by its terms and conditions. We also agree and undertake to enter into the Funding Agreement in such form and substance and within such time as may be specified by the Government. We acknowledge that the execution of the Funding Agreement aforesaid shall be a condition precedent to the offer of a Grant (if any).
Authorised Signature
with Organisation Chop
(For and On behalf of
the Applicant/Organisation) / Name of Signatory
Name of Applicant/Organisation / Position/Post Title
/ / (Date)
In the case of a joint application, each of the parties constituting the applicant/organisation must sign below.
Authorised Signature
with Organisation Chop
(For and On behalf of
the Joint Applicant/Organisation) / Name of Signatory
Name of Joint Applicant/Organisation / Position/Post Title
/ / (Date)

Section E

Checklist for Submission of Application
The original application form has been completed and duly signed by the applicant/organisation and the joint applicant(s)/organisation(s) (if applicable).
Provision of documentary proof of the registration information of the applicant/organisation (relevant registration certificates and relateddocuments, includingCompany’s Memorandum and Articles of Association as applicable) and that of the joint applicant(s)/organisation(s) (if applicable).
Provision of documentary proof on the non-profit-sharing status and bona fide nature of the applicant/organisation and that of the joint applicant(s)/organisation(s)(if applicable).
Provision of documentary proof of secured non-government sponsorship and/or donation.
Provision of documentary evidenceon other funding for the proposal.
Provision of notification(s) or letter(s) of intent of the key artistic personnel and other supporting staff.
Provision of recording or documentation of up to 3 previous works (if available) for reference.
2copies of the completed application form plus 2 copies each of the above supporting documents/information are attached.
1 electronic copy (text information in Word format & budget in Excel format) of the completed application form (together with supporting documents/information)stored in USB/CD-ROMis attached.
Methods of Submission of Application
The original completed application form together with the above documents should reach the Secretariat of the Arts Capacity Development Funding Scheme by post or in person at Home Affairs Bureau, 25/F Wanchai Tower, 12 Harbour Road, Wan Chai,Hong Kong by6pm on 8January 2016.

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