Grant Application

The Rudolf Nureyev® Dance Foundation

Grant Application Form to fill in, print and fax to (312) 787-7534

The Foundation's address is 308 W. Erie Street, Suite 700, Chicago, IL 60654

Grant Request

Amount requested:
This request is for: Dance Performance Dance Education and Community Outreach
                            New Choreography Dance Publication
                            Dance Preservation Dance Film Production and Presentation
                            Dance Revival         Dance Scholarships and Endowment Funds
Project Title:

Organization Information

Organization name:
Street Address :
City, Sate, Zip:
Telephone: Fax: E-mail:
Executive Director:          Telephone:
Name of contact person: Telephone:
Total organization budget for current year:
Date of incorporation: FEIN or equivalent:

Is your organization tax exempt under Section 501(c)(3)? Yes No
If not, do you have a fiscal agent? (please identify the organization, contact person, and telephone number)

Summarize the organization's mission:

Summarize the purpose of your request:

What is the time frame in which the funds will be used ?

From: To:

List other private and public funding sources for this particular request.
Funding sources to date Amount Date received

Funding sources pending Amount Anticipated Date

Organization Budget (last fiscal year)
Expenses Revenues

Program Budget

Name & Title Date:

Either fax this application to (312) 787-7534, press the submit button below, or e-mail to barry@weinstein1.com.

Proposal Narrative

A. Background
1.    Organization's mission, history, overall goals and/or objectives
2.    Description of current programs and activities. Please emphasize major achievements of the past two years.
3.    Description of formal and informal relationships with other organizations.

B. Purpose of funding request
1.    Briefly state how this grant will be used.
2.    If your request is for a specific project or capital campaign, please provide the following information:
       a. Describe how this project will benefit the dance community's needs in the United States.
       b. What audience or community population will be served?
       c. How will the grant be acknowledged and how will it reflect well on the legacy of Rudolf Nureyev?
       d. Describe the capital campaign strategy, goals and objectives, the timetable for accomplishing these goals.
       e. Once the funds are in hand, what is the schedule for the project or program's production and implementation?
       c. If this is a collaboration, briefly describe the partners. Include letters of agreement from the collaborating agencies.
       d. If this is a request for a specific program, explain how it will be supported after termination of the grant.

C. Evaluation
1.    How will you measure the success of your project or program?
2.    Describe your criteria for success.
3.    Describe the results you expect to achieve by the end of the funding period.

Required Attachments

A. Finances
1.    Audited financial statements for the last fiscal year, if available, or unaudited financial statement.
2.    Current years' operating budget including projected expenses and revenues.
3.    Program budget.
4.    If request is for a multi-year grant, include multi-year program budget.
5.    List of Board of Directors with related employment affiliation.
6.    List of staff and their professional qualifications.
7.    List of foundations, corporations, or governmental agencies which funded the organization in the prior fiscal year.
8.    Itemized used of requested funds.

B. Other Supporting Materials
1.    Verification of the organization's or fiscal agent's tax-exempt status under Section 501(c)(3) of the IRS code. If using a fiscal agent, please include Letter of Authorization.
2.    Grantee report if previously funded.
3.    Latest annual report and summary or the organization's prior year's activities.
4.    Letters of support and/or reviews.

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