Individual/Organization Name

ROOTS Member First Name

ROOTS Member Last Name

Application Contact Person (if different from Member)

Phone

Website

Mailing Address

City

State/Province

Postal Code

Please provide a personal and/or artistic mission statement.

Please describe your project in 200 words or less.

Are other artists or organizations involved in the project?

How does your project support and relate to the mission and membership of Alternate ROOTS?

Are you seeking a fiscal sponsor for one specific grant application or for an ongoing fiscal sponsorship relationship?

If you are seeking a sponsor for one specific grant please submit a copy of the grant application and project budget

What is the estimated timeline or time frame for your project and fiscal sponsorship?

What are your plans for fundraising?

Will you be soliciting individual donations through your website?

Will you be applying for grants?

What is your estimate of the total funds your project will receive annually through fiscal sponsorship?

Please attach a copy of your organizational and/or project budget.

Is there anything else we need to know about your application?