APPLICATION FORM FOR FUNDING ARTS ORGANISATION: 1 st April 2016 to 31 st March 2017

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APPLICATION FORM FOR FUNDING ARTS ORGANISATION: 1 st April 2016 to 31 st March 2017 NB : If you are an individual artist, do not use this application form, use the appropriate one for individuals. Annual Funding Closing Date: 29 April 2016 Outcomes Available: 31 August 2016 1. Name of the proposed project (if applicable): 2. ORGANISATIONAL DETAILS Name of organisation: District : Town: Physical address of organisation : : Postal address of organisation : : Postal code : Website : 3. CONTACT PERSON OF THE ORGANISATION Contact person : Physical address : Tel/Cell E-mail address : Fax: : ID No. Position held in the organisation : 1

4. Profile of your organisation 4.1 Brief history of your organisation : [When was it established; Why was it established; How many people are involved in running your organisation] 4.2 List major artistic achievements of your organisation in Arts and Culture over the past two years: 4.3 Is your organisation registered: Yes [ ] No [ ] If Yes provide the registration number: If No explain the reasons 2

4.4. The structure of your organisation: Who else is involved in the running of the organisation? To be completed in full. 1.Name and Surname Position SA ID Number Tel or Cell 2.Name and Surname Position SA ID Number Tel or Cell 3.Name and Surname Position SA ID Number Tel or Cell 4.Name and Surname Position SA ID Number Tel or Cell 5.Name and Surname Position SA ID Number Tel or Cell 6.Name and Surname Position SA ID Number Tel or Cell 7.Name and Surname Position SA ID Number Tel or Cell 4.5 Employee breakdown of your organisation as a whole. Projects must ensure that this breakdown agrees with the number of people involved in their projects in section 4.1 Full-time Disabled Adult Female (e.g. 3 black, 4 coloured or 5 white) Adult Male (e.g. 3 black, 4 coloured or 5 white) Youth Age 35yrs and below (e.g. 3 black, 4 coloured or 5 white) Part-time Volunteers 4.6 Statistics of beneficiaries of the project Disabled Youth Women Rural Urban Race Males Females NB. Section 4.6 has no bearing on the content of the application nor outcomes of the Council. It only assists ECPACC with demographical research and information. 5. Project Details 3

5.1 Artform you are applying for: Mark with an X the appropriate block and not more than one: Craft Dance Drama Festival Film Literature Multi Discipline Music Visual Arts 5.2 Detailed description of the project applied for : If you are applying to conduct a workshop/training note the following: Submit a list and details of the people you will workshop (not less than five and not more than ten). Submit the summary of the content of the workshop with complete outcomes and assessment methods. Submit the resume / curriculum vitae of the facilitator. Submit a detailed outline of the follow-up mentoring to the workshop. 5.3 Start of the Project: End of the Project: 5.4 Date of the proposed event (if applicable): 4

6. Give a detailed programme of action or timetable of your project activities. This section should agree with section 7.1 which is your project budget breakdown. Activity Starting Date Ending Date NB. The following are examples of activities for art projects, select what is appropriate and/or applicable for your project. Theatre Dance Music Literature * Development * Auditions * Rehearsals * Dress Rehearsals * Performances, etc. * Development * Auditions * Rehearsals * Dress Rehearsals * Performances, etc. * Development * Rehearsals * Performances * Research * Writing Process * Consultation : [Editors & Proofing] * Typesetting & Design * Publishing Craft Visual Arts Filming Festival * Design & Development * Production * Exhibitions, vending or selling to public * Design & Development * Production * Exhibitions, vending or selling to public * Script Development * Pre-Production * Pitching * Production * Post Production * Development and Branding * Securing artists & other necessities like PA System, accommodation, etc 5

7. Project Budget Breakdown 7.1 Budget Breakdown Table Item Description Amount Grand Total NB. Submit all the relevant quotations for items budgeted for, i.e. every line item in your budget must have a quotation accompanying it. 7.2 Mention all the other organisations and companies that you have applied to : 1. Name of Other Organisation/Company Amount Requested Amount Received 2. 3. 4. 5. Grand Total 6

7.3 Banking details of the project: Name of the account Bank Branch Name Account Number : : : : 8. References Provide the names of two people who know both your organisation and your project who can be contacted by ECPACC. [Do not provide names of your relatives or friends or people involved in your project.] 1. Name : Address : Tel/Cell : Fax. : Role In Arts or Community : 2. Name: Address: Tel/Cell: Fax. : Role In Arts or Community: * Attach the letters of reference from the referees mentioned here above. 9. Declaration All the information given above is genuine and true to the best of my knowledge. I also understand that if any of the information given above is found not to be true, this application will be disqualified and rejected. Full name/s of the person completing this application on behalf of the organisation: Designation in the organisation: Submit a certified copy of representative s SA ID, certification stamp should not be more than three months old. Signature: Place Date Witness: Full Names Signature Date 7

10. PROCEDURE FOR THE SUBMISSION OF APPLICATION FORMS: 1. Post or courier or hand delivers your complete application form to ECPACC Office in East London. Faxed or e-mailed application form will not be accepted. The address is provided here below. 2. An ECPACC representative and a Department of Arts and Culture District Office official will arrange for the pre-assessment of your project in your district. 3. The ECPACC Full Council, upon receipt of a recommendation from the ECPACC representative and a Department of Arts and Culture District Office official will take a decision on your application. 4. Preference for funding will be given to artistic programs such as performance fees, venue hire, transport hire, costumes, art enhancing material, marketing and publicity and artistic grant. 5. In line with the strategic priorities of government, projects co-ordinated by persons with disabilities, youth, women and rural communities will receive priority. 6. Projects must be housed at the address indicated on the application form where all official visits will be conducted. 7. Churches, political parties, businesses, schools, salaries and ongoing project running costs are not funded by ECPACC. 8. Acceptance to a Festival is no guarantee for funding from ECPACC. The Application form should be accompanied by proof of acceptance and/or registration letter from the Festival. 9. Incomplete forms will be automatically rejected, it is imperative that you submit quotations for all budgeted items with your application form. 10. Your application form must reach us by the closing date as late applications will not be considered. Organisation and individuals can only be funded once per year. Projects not approved for funding may submit a new application form for the next funding session which will be tabled in the next funding cycle (following year). 11. Send your applications to : Arts Development Manager ECPACC 16 Elton Street PO Box 18372 Southernwood or Quigney East London East London 5200 5211 Contacts Tel. 043-743 6187 Fax. 043-742 0109 Website www.ecpacc.co.za 8

CHECKLIST FOR DOCUMENTS / INFORMATION REQUIRED: No. Documents / Information required Yes / No 1 Completed ECPACC application form 2 Drama Production: Script attached 3 Workshop: Relevant documentation as per requirement attached 4 Book publishing: First three chapters of your book or first ten poems for poetry writing attached 5 Quotations attached 6 Certified copy of the applicant s SA ID or Passport attached 7 Festival application: Proof of registration with the festival attached 9