Art is a catalyst
for personal empowerment, creativity, community building and positive
social change.
SYNERGY ART FOUNDATION
251 Barbara Ave.
Solana Beach, California 92075 | Tel and Fax: (858) 509 1155
| Email: nnartd@gmail.com
SD- Emergency Artist Support League The SD-EASL Fund provides limited
financial assistance to San Diego County arts professionals
who are in dire temporary distress because of an unforeseen
medical emergency or other catastrophic event. The range of grant available is $1,000 - $3,000 per event,
annually. The SD-EASL Fund is open to non-profit arts organizations,
that have functioned productively in San Diego County for a
minimum of five years, as evidenced by a tax records, exhibitions
and/or performances, and significant involvement in the San
Diego arts community. Please answer all questions completely and all requested
materials must be enclosed in order for your application to
be evaluated. Organization _____________________________________________ Email ______________________________ Address
________________________________City ______________ County____________________________ State _____ Zip __________________ Phone _______________________ Fax ________________________ Executive Director ___________________________________________________________________________ 501 (c) 3 since date ________________________ What is the nature of your emergency? Date of emergency ______________________ Estimate of total amount needed to recover, pay bills,
etc. $ _________ How much money are you requesting from the SD-EASL Fund?
$ _________ Service provided
_____________________________________________________________________
Administered
by Synergy Art FoundationGrant
Application for Arts Organizations
Limit your description to the space below. Attach documentation
where possible or appropriate (i.e. minutes of board meeting,
doctor/hospital bills, police report, eviction notices, utilities
notices, newspaper article, etc.).
Synergy Art Foundation prefers that checks be written to service
providers. List in priority those who would receive payment from your
grant.
Check written to ___________________________________________ Amount $_________________
SD-EASL
Grant Application/Page Two
Employed? ___
Full-time ___ Part-time ___
How long? _______________
If yes, list current employer, name, address, phone number. If no, list last
employer and ending date of last employment.
If self-employed, please state for how long and annual average
income over the past 3 years?
List
all sources of income.
What
other grants or funding (i.e. insurance, fundraising efforts, etc.) have you
received related to this emergency?
We
may require proof of your financial status and/or residency (driver's
license, voters registration card, etc.) Is such documentation available? If
not, please explain.
List three references who would know about your current situation.
Include their addresses, telephone numbers and your relationship to them.
1.
2.
3.
List at least one professional reference who can verify your status as
an arts professional.
How did you learn about SD-EASL?
As
documentation of your professional status and exhibition/performing arts
history, please enclose/attach your resume.
Signature of applicant
_______________________________________________ Date
_____________________________
Send this completed form to:
Synergy Art Foundation SD-EASL
251 Barbara Avenue, Solana Beach, CA
92075
or email to nnartd@gmail.com
All information received
regarding this application will remain strictly confidential.