Lesbian Culture & Creativity Grant Application

( DUE May 2001)

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Contact Information

Your Email Address
Contact Name
Name of Group/Act
Street Address
City	State Zip Code
Phone Number (Day)	Is it OK to leave a message about the Grant
	at this number? Yes No
Phone Number (Eve)	Is it OK to leave a message about the Grant
	at this number? Yes No

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Demographic Information (Optional, but is part of the award criteria).

 

Do You/All Group Members define yourself as Lesbian?Yes No

Age(s):

Race(s)/Ethnicity:

Differently Abled:Yes No

If so, please describe

(describe)

Income(s)?

$6,000 or less   

$6,000 - $12,000

$12,000 - $18,000

$18,000 or more

 

Are you low income by choice? Yes No (Example: are you a student?)

 

Are you a past Lesbian Variety Show participant? Yes No

If yes, the names of groups/participant and dates of participation:

(describe)

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Grant Information

A. How much money are you requesting?

B. How will this grant assist your artistic development? (No More than 1/2 page).

(describe)

C. Please describe how you propose to use the grant monies to accomplish the above. (No More than 1/2 page)

(describe)

D. How will the Lesbian Community benefit from you receiving this assistance? (No More than 1/2 page)

(describe)

E. Please provide a detailed budget describing how you will use this money. Receipts will be required. A Variety Show performance, display, or product copy Will be required if a grant is accepted when applicable. (No More than 1/2 page)

(describe)