APPLICATION FORM PROFESSIONAL PROJECT ASSISTANCE ARTS PERIODICALS

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RETURN TO: British Columbia Arts Council 20-014 Mailing Address: Box 9819, Stn Prov Govt Victoria, BC V8W 9W3 Tel: (250) 356-1718 Fax: (250) 387-4099 Location Address: 800 Johnson Street, 2 nd Floor Victoria, BC V8W 1N3 E-mail: bcartscouncil@gov.bc.ca Website: www.bcartscouncil.ca APPLICATION FORM PROFESSIONAL PROJECT ASSISTANCE ARTS PERIODICALS Will you have an overdue FINAL REPORT on a previous BC Arts Council Award as of the deadline date for this program? NO You can continue YES You are Ineligible to apply for this program Applicants are strongly urged to discuss their project proposal with the appropriate program officer before submission. Please read all guidelines and eligibility criteria before completing form. ORGANIZATION or APPLICANT NAME (Legally Registered Name) FOR BCAC USE ONLY: 20 22 MAILING ADDRESS FILE # Postal Code Telephone E-mail $ Amount Requested Fax Website Dates of Project (yyyy/mm/dd): Title From To: Telephone Submitting Officer (Print Name) E-mail Most recent BCAC Project Award (if applicable) TO BE COMPLETED BY ORGANIZATIONS ONLY Program: Director (Print Name) Board Chair President (Print Name) $ Year (yyyy): DECLARATION (Original signatures required) FOR NON-PROFIT SOCIETIES Signature of Submitting Officer Date signed BC Society Act # Signature of Board Chair or President (Organizations only) Date signed Date Registered (yyyy/mm/dd) DO SOLEMNLY DECLARE: (a) THAT, TO THE BEST OF MY KNOWLEDGE, THE INFORMATION GIVEN IN THIS APPLICATION IS COMPLETE AND TRUE IN EVERY RESPECT AND, (b) THAT THE SOCIETY HAS COMPLIED WITH ALL REQUIREMENTS OF THE CRIMINAL RECORDS REVIEW ACT AND THE SOCIETY ACT IN EVERY RESPECT APPLICABLE TO THE SOCIETY. (c) THAT THIS APPLICATION HAS BEEN APPROVED BY THE BOARD OF DIRECTORS OF THE SOCIETY. Federal Charitable Tax # (if applicable) Fiscal Year End Month (mm) Day (dd) Total Project Budget (Costs): $ FOR COLLECTIVES Total Operating Budget (for organizations) $ $ (Previous Year) (Current Year) Social Insurance Number of Key Contact PLEASE CHOOSE ONE: Print Periodicals Electronic Periodicals Please describe your project briefly (25 word maximum) for the adjudication committee by completing this sentence: Funding is requested to assist with... Please also sign Appendix A which will not be submitted to the jury. Required Documents Attached: All items on Checklist (page 7)

DETAILED EXPENSES Omit cents Please refer to program guidelines for ineligible expenses. Provide detailed notes as required, either in the form or on a separate page, as needed. NOTE: This is a generic form. Not all fields will apply to all projects. Page 2 of 7 EXPENSES Project Forecast Do not write in this column 1 PRODUCTION EXPENSES 2 Salaries and Fees: Editorial staff and guests 3 Contributors' Fees: Writers and Collaborators 4 Art and photo fees, copyright 5 Pre-press 6 Online Version and Hosting/ecommerce costs 7 Printing and Binding 8 Distribution: mailing, shipping and handling 9 Other, including In-kind (Specify) 10 TOTAL PRODUCTION EXPENSES Lines 2 to 9 11 ADMINISTRATIVE EXPENSES 12 Salaries and Benefits: Administrative and Marketing 13 Office Rent 14 Office Supplies 15 Bank Charges 16 Legal Fees, Audit, etc. 17 Travel (Admin. Only) 18 Telecommunications 19 Advertising: Ad sales, Exchange ads 20 Subscription and Single Copy Promotion 21 Fundraising Costs 22 Other, including In-kind (Specify) 23 TOTAL ADMINISTRATIVE EXPENSES Lines 12 to 22 24 TOTAL ALL EXPENSES Line 10 + 23

DETAILED REVENUES Omit cents Page 3 of 7 Indicate whether revenues are confirmed or pending at time of application by inserting a C or a P in the designated column. Identify in-kind expenses to correspond with in-kind revenues. Provide detailed notes as required, either in the form or on a separate page, as needed. Under normal circumstances, project revenues should be equal to project expenses; if not, please provide a detailed explanation. NOTE: This is a generic form. Not all fields will apply to all projects. REVENUES C/P Project Forecast Do not write in this column 1 EARNED REVENUES 2 Subscriptions: individual and institutional 3 Single copy of newsstand sales 4 Digital subscription or single digital copy sales 5 Advertising 6 Other (Specify) 7 TOTAL EARNED REVENUES Line 2 to 6 8 PRIVATE SECTOR REVENUES 9 Foundations (Specify) 10 Sponsorship 11 Fundraising 12 Endowment 13 Other, including In-kind (Specify) 14 TOTAL PRIVATE SECTOR REVENUES Line 9 to 13 15 GRANT REVENUES 16 BC Arts Council: Operating 17 Project 18 Government of BC: Other (Specify) 19 Canada Council: Operating 20 Project 21 Other (Specify) 22 Federal Employment Program 23 Other Federal (Specify) 24 Local Government 25 Post-Secondary Institution 26 Student Society 27. Community Gaming Grants 28. Other (Specify) 29. TOTAL GRANT REVENUES Line 16 to 28 30. TOTAL ALL REVENUES Line 7 + 14 + 29 31. SUMMARY 32. TOTAL REVENUES Line 30 33. TOTAL EXPENSES Line 24 (p. 4) 34 SURPLUS/(DEFICIT) Line 32 33

Page 4 of 7 IMPORTANT: WRITTEN STATEMENT AND SUPPORT MATERIAL ALL APPLICANTS ARE REQUIRED TO READ THE PROJECT ASSISTANCE GUIDELINES The written statement, accompanied by the submitted support material, forms the basis of assessment for each application. Applications will be evaluated by a peer assessment jury against the program criteria, the core values and goals of the BC Arts Council and the three areas of assessment. In preparing their proposal, applicants should: Consider and discuss how the project addresses their mandate, mission and values through the pursuit of excellence in each of the three areas of assessment. Respond to the core values and goals of Council in considering and discussing each of the three areas of assessment as they relate to the project. All applicants should refer to the core values and goals of the BC Arts Council s Strategic Plan 2014-18 alongside the Assessment Criteria section of the PROFESSIONAL PROJECT ASSISTANCE - ARTS PERIODICALS guidelines in preparing their proposals. Applicants are reminded that while they are asked to consider a number of possible criteria under each area of assessment, not all of the criteria will apply to each other application; rather, they are examples of aspects that should be considered and addressed in the application if relevant to the applicant and the project being proposed. The relative weight given to each of these areas of assessment is indicated in brackets. 1. Artistic/Editorial Achievement (50%) 2. Community Engagement (25%) 3. Feasibility (25%) Each applicant must submit the following written statement in five parts, following the numbered order below.(maximum 4 pages total, font size 11 or larger, on single-side white paper without staples). The BC Arts Council believes that artists and arts organizations are well placed to assess the work they produce. As a result, an essential element of each written statement is insightful, critical self-reflection. Jury members want to understand the applicant s assessment of the challenges faced and the creative solutions under consideration. 1. Please summarize the periodical issues for which you are requesting assistance, including: A brief summary of the project, including title if applicable/determined. The rationale and objectives underlying the project s artistic and editorial choices. A list of participants or contributors, according to area of responsibility for this project. 2. Please provide a profile of the applicant, including: The organization s mandate, mission and values (as applicable). A summary of the applicant s history in creating, developing, producing or disseminating arts periodicals in British Columbia.

Page 5 of 7 WRITTEN STATEMENT continued 3. What were the organization s achievements in serving authors, the audience and broader communities during the last fiscal year (2016/17)? Please provide information regarding the organization s activities supporting the professional development of writers. The level of payments to contributors relative to your overall budget should be discussed. Please describe the organization s initiatives to increase circulation, reach new audiences and market the periodical. 4. Please describe up to three aspects of the project that will strengthen the arts and periodical publishing community. All projects are devised to involve particular artists, audiences, publics and/or communities. This question encourages the applicant to identify the particular artists, audiences, publics and/or communities involved and to show how the project will offer stimulating and varied forms of engagement. Engagement may include supporting the creation or publication of literary work or social, cultural, or intellectual commentary or inquiry; the development of literary and related artists or professionals; audience engagement and participation; organizational development; discourse; and/or education. 5. Please provide a statement outlining measures planned or taken to ensure successful realization of the project, both artistically and financially. Please contact your program officer if there are significant changes or updates to the project proposal after the application deadline. The deadline for Professional Project Assistance - Arts Periodicals applications is April 15, 2017 Applications are accepted by mail and must be postmarked by Canada Post or a courier company no later than April 15, 2017. Applications may be hand delivered or delivered by courier to 800 Johnson Street, Victoria, BC, up to 4:00 p.m. on the deadline day. Applications by email or fax will not be accepted. Note: if the deadline falls on a weekend or statutory holiday the deadline becomes the next business day.

Page 6 of 7 PROGRAM INFORMATION SHEET ARTS PERIODICALS PROGRAM INFORMATION FOR THE PERIODICAL S CURRENT FISCAL YEAR. If you require additional space, please type your entire list on an attached sheet. Issue/Project Title (number/url) Date Published Principal Writers Artists/ Designers Editors Printer PROGRAM INFORMATION FOR THE PERIODICAL S PROJECTED FISCAL YEAR. If you require additional space, please type your entire list on an attached sheet. Issue/Project Title (number/url) Date Published Principal Writers Artists/ Designers Editors Printer

Page 7 of 7 APPLICATION CHECKLIST It is the applicant s responsibility to ensure applications are complete and all application requirements are included. The BC Arts Council will not contact applicants to address errors in applications or missing application requirements, including support material, other than that required to determine eligibility. Eligible applications and any supporting material will be assessed as they have been submitted. Application packages must be assembled in the order listed below. The application should be printed on single-sided, standard letter-sized white paper and submitted unbound and without staples. Before you submit your application, ensure that you have included the following: A signed, completed Professional Project Assistance Arts Periodicals application form (page one). A written statement (see page 4) of no more than four pages, font size 11 or larger, which addresses all application questions by number and includes details of the proposed project. A list of the organization's current board of directors, including their occupations and start dates (for registered, non-profit organizations only). A list of administrative and artistic/editorial staff or significant contractors, giving name and title or responsibility and indicating if permanent/seasonal and full-time/part-time (for registered, non-profit organizations only). Maximum 250-word bio for each member of the project s creative team. Please do not send CVs. A statement indicating frequency of publication and printing/online release and circulation information. Completed Program Information Sheet Arts Periodicals (page 6). Two letters of reference from established professionals familiar with the work of the organization. (for applicants who have not previously received funding through this program only. Letters of support are optional for previous recipients of awards under this program.) An interim report (max. 1-page) on earlier phases of this project funded through the BC Arts Council that are still underway and for which you have not yet submitted a final report, as applicable. A statement of editorial policy. The names of publishers, editors and members of the editorial board. A balanced project budget, using the budget form provided (including detailed notes, either in the form or on a separate page as needed). Material supporting the history of the applicant s development, creation, production, or dissemination of their discipline in British Columbia, including any appropriate press or critical documentation. A signed, completed copy of Appendix A (for collectives only). An operating budget for the fiscal year in which the proposed project takes place (for registered, nonprofit organizations only). One copy of the organization s most recent Financial Statements; see Guidelines for details (for registered, non-profit organizations only). Six copies of two selected issues or editions of the periodicals published over the past year OR specific URLs that allow access to electronic periodical content over the past year. In the case of unincorporated independent collectives, a key contact person (listed as the submitting officer) will be held responsible for the application. If the application is successful, the key contact person will receive payment of the award on behalf of the group and must submit a final report upon completion of the project. Support material will not be returned and will be circulated to the jury only at the time of the adjudication.

DECLARATION OF APPLICANT A APPENDIX A (Required for Individual, Ensemble and Collective Applicants) I, of the city of, in the Province of British Columbia, do solemnly declare that, to the best of my knowledge, the information given in this application is complete and true in every respect, and that I comply with all applicable requirements of the Criminal Records Review Act. Furthermore I acknowledge that the personal information provided here is subject to the privacy provisions of the Freedom of Information and Protection of Privacy Act and that by signing this form I consent to its use as follows: The personal information collected on this form is collected pursuant to the Freedom of Information and Protection of Privacy Act and will be used to administer the BC Arts Council Professional Projects programs and process your application. Successful award recipients' names, resident location and the amount of the award may be published in the Annual Report of the British Columbia Arts Council as well as in various communications and promotional vehicles of the British Columbia Arts Council and Government of British Columbia. Social Insurance Numbers will be disclosed to Canada Revenue Agency through the issuance of T4As. Any questions about the collection, use and disclosure of personal information should be directed to the BC Arts Council at the contact information listed on the first page of this form. Date (yyyy/mm/dd) Signature of Applicant