This sample application was taken from the Massachusetts Cultural
Council grant application. The submitted application need not look
exactly like this, but should contain the same information.
- Applicant name:
- Applicant name also known as:
- Mailing Address (if different):
- Chairperson (name, title):
- Executive Director (name, title):
- Project contact (name, title):
- Email address:
- Daytime telephone:
- Summarize the mission of your organization:
- Last fiscal year total income:
- Last fiscal year total expenses:
- Title of project:
- Summary of proposed project:
- Project start date:
- Project end date:
- Number of individuals directly participating in/benefitting from this project:
If different than the information above,
- To whom should the check be made out to?
- Where should it be mailed to?
- The signature below is that of the person authorized to testify
as to the accuracy of this application (signature/title/date):