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GRANT APPLICATION FORM

Please Note: We strongly suggest that you compose your answers in a Word document, save it, and then copy and paste your answers into the online form below. For your convenience, click here to download the questions in a Word document.


*  =  Required Field
I. Contact Information

Name of applicant program: *
Name of umbrella organization:
Contact person's name: *
Title: *
Phone number: *  xxx-xxx-xxxx
Fax number:  xxx-xxx-xxxx
Email address: *
Website:
Shipping Information:
Company name: *
Attn: *
Address: *
City: *
State: *
Zip: *
Mailing Information:
Same as shipping address.
Company name: *
Attn: *
Address: *
City: *
State: *
Zip: *





II. Financial Information

Attach this year's detailed applicant program budget: *
Note: File names can not contain any spaces or special characters.
The organization is a nonprofit that classifies as: *
501(c)(3)   governmental organization
(this includes public schools)
When did the organization receive 501(c)(3) status? *
What is the program�s EIN? *
Please attach proof of the
organization's 501(c)(3) status
with this application.: 		*
Note: File names can not contain any spaces or special characters.
How much money did this specific music education program raise last year (Jan. 1 - Dec. 31)? *
Note: This answer should be in numerical digits only, no punctuation.
How much money do you expect your program to raise this year? *
Note: This answer should be in numerical digits only, no punctuation.
How does this program fundraise? *
Please list and describe fully the sources of funding other than the fundraising efforts listed above:





III. The Applicant Program

Mission and/or vision statement for the organization and/or program: *
Please describe the specific applicant music education program in 100 words or less: *
Exactly how is music taught in the applicant program? Please describe the curriculum in 500 words or less.
*
In 20 words or less, what is unique about this applicant program? *
When was a music education program established at this organization? *
When was the specific applicant program established? *
If the program was established
less than a year ago, what has
been accomplished and what
is left to be done?
Have you applied for a grant
from the Fender Music
Foundation before?		 * Yes   No
If so, when? *
Were you awarded a grant
or given a donation?		 Yes   No
How did you hear
about the foundation? 		*





IV. Program Participants

Describe the demographics
and ages of the program�s
participants/students that
would benefit from
this grant? 		*
In what areas do the
program�s participants/
students live that would
benefit from this grant? 		*





V. Request

Please note that if you are requesting instruments or equipment, the foundation will only be able to provide what is traditionally sold through Fender or Musician's Friend; if any other instruments or equipment are needed, the foundation would only be able to donate money or memorabilia so that the program can purchase instruments or equipment independently.
Would you consider auctioning
signed music memorabilia to
raise funds for your program? 		* Yes   No

What are you requesting from The Fender Music Foundation?
Please note that the items do not have to be sold at Fender.
 
Item Quantity Retail
price per item		 Retail
total price		 Where did you find the retail price for this item?
Grand total
How many participants would play the instruments or use this equipment each year? *
How long would these items or money last in the program?
For the life of the instruments/equipment? 		*
If instruments are awarded,
how do you plan to pay for their maintenance and repair? 		*
Describe the compelling need
for the items you have requested in 300 words or less. 		*





VI. Statements

How will this grant enable more people to participate in music in 100 words or less? *
What does the applicant program mean to you in 100 words or less? *
Who else has a strong sense
of pride in the program? 		*
How is your community affected by the program in 100 words or less? *
Please attach 1 (one)
student/participant�s personal
statements on what the
applicant program and music
education mean to them:		 *
Note: File names can not contain any spaces or special characters.





VII. Affirmation

Name: *
Title: *
* a) By initialing here, I attest that the applicant program does fit within the requirements of a grant from The Fender Music Foundation.
* b) By initialing here, I hereby affirm that I have printed, read, understand, and agree to the provisions set forth in the Agreement Form on behalf of the applicant program.
* c) By initialing here, I hereby affirm that the electronically submitted application is true and correct.
* d) By initialing here, I hereby grant permission and license to The Fender Music Foundation to use the following in connection with its promotional materials (including print, websites and any other medium):
  • The Name and Logo of the applicant organization.
  • All photos the applicant organization submits to The Fender Music Foundation.
  • All statements and information the applicant organization supplies to The Fender Music Foundation from all sources (including in this application and all supplemental information and requested correspondence).





VIII. Additional Notes

Additional Notes:




Note: If the combined size of the attached documents exceeds 3.5 MB you will arrive at a confirmation page. However, your application will not have gone through.






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