Arts Express! Grant Program Application Applicant Name* First Last Contact Person* First Last Contact Person TitleAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Website About the ProjectProject Description*Communities Served*Project Impact*Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY Grant Request Amount*Total Project Cost*Is this a new project or activity?*YesNoUpload DocumentsPlease upload the required (.doc, .docx and/or .pdf) documents with your cover sheetProject Budget*Description of Organization OR Resume*Work Samples (images or video links of artistic work from within the last 3 years)ConfirmationSignature of Applicant*Today's Date* Date Format: MM slash DD slash YYYY Acceptance:* By clicking this box you are stating that all information you have provided is true to the best of your knowledge and that the signature above is indeed you
